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��'�� � �� <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVFRETT,WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 <br /> ���a-�C�k ��� �i 7c�,A o � iQ no @� �l�Cy--1 <br /> PROJECT ADDRESS r , (� `' (�U�VI ��.S��.y� � <br /> �t-�... t�.-."r� ��-��N'1(10 Tl t�a"l \ ���1 (•1.4... 1\ 1 n_ �9 l0l�[1� �� "IC,Y�1, `���{�r.a0-J'1 <br /> 1----- -- ---–- - — Phone <br /> Owne� Meil Address .Cily Slele2ip <br /> Mail Addrass Cily SlatelZip Phone <br /> Tenant (425)653-4085 <br /> Electro Serve LLC 13300 SE 30th ST. Suite 105 Bellevue WA 9800none <br /> Eieclrical Conlrector Maii Address City StatelZJp <br /> ELECTSL042M2 _— ��V�a o�� <br /> Stale License Number Contract Price of Work <br /> Proposed Use of Bui�ding Conlact Person (Plun Review) <br /> Description of Work to Be Done: \ <br /> � - � �..r� QOf 11( D <br /> NOTE: PLANS FOR ELECTRICAL WORK AT EDUCATIONAL, FACILITIES UTILIZING STATE FUNDS MUST BE <br /> APPROVED BY THE STATE OF WASHINGTO��. APPLICANTS WITH SUCH JOBS MUST SHOW THE STATE <br /> EDUCATIONA FACILITIES AND A L HEALTH C E FACILITI SI PLANS WILL E REVIEWED BY THIS OFFI OE HER <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO 8E IN RACEWAYS, MC OR AC CABLE. <br /> HANDICAPPED ACCESSIBILITY: ELECTRICAL AND COMMUNICATIONS SYSTEM RECEPTACLES ON WALLS <br /> OF 5I NCH SSABOVE THE FLOOR AWAC 5120 SEC 83106(OZTES OF TRAVEL SHALL BE MOUNTED A MINIMUM <br /> ENVIRONMENTAL AND OTHER CONTROL RECEPTACLES AND OTHER OPERABLE EQUIPMENT WITHIN <br /> RANGES OF WAC 5E 20 SEC.SN 6(b�E 8 F AND NOT L SS THANv 6LINCHES ABOV�E THE�F OIOR.N THE REACH <br /> 1 HEREBY CERTIFY THAT 1 NAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br /> PROVISIONS OF LA WS AND ORDINANCES C,OVERNING 7HI5 TYPE OF WORK WILL BE COMPLETED WHETHER SPECIFIED HEREIN OR NOT, <br /> THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVEAUiHORITY 70 VIOLATE OR CANCEL THE PROVISIONS OFRN"OTHER STATE <br /> OR LOCAL LAW REGULATING CONSTRUCiION OR THE PERFORMANCE OF CONSTRUCTION. THAT 1 AM AUTHORIZED BY THE OWNER OF <br /> RC'W AND 29G.200 N ACRFORM THE WORK FOR WHICH APPLICATION IS MADE AND 1 COMPLY WITH TNE STATE CONTRAC70RS LA W 78.27 <br /> ` �p FEE ��. Lx� <br /> SignaWru Dalti <br /> ELECAP(RCV 8R001) �p 3(D 'p�7 <br />