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TM� <br /> ..�, � <br /> APPLICATIVN FOR ELECTRICAL r ERI�!!T �� <br /> :ITY CF • <br /> evere#t ��: . <br /> ��� 9UI�DING DEPAfiTMENT ' <br /> a�y 359•8810 / <br /> x cJ <br /> x� �,l% <br /> y x h�+ <br /> � H� a+ Cress ty P hone <br /> nner <br /> "��1 F�-I� / ' ) '_'� � /n .J�L� /�//�ii7f�GL' !: �. ° ��b/ �� <br /> VJ H ' _�—/� � one ' � <br /> H e a� S! n '^a���aress F tY � P � 'I <br /> x J73o <br /> � �d <br /> /J i� s • r .�^D :�•i`f� G�i /.� ) �1 ��7Go� �� SfS�� cenee <br /> O H c eetr ea ontractor ai tl ress �Y P <br /> � �g ,�. J/ • _� ' /G ! ' e`vf�/�"a � .?vi ��1/9 7lL-'iF -c%r'/� � <br /> �,� � 7L--� G '< <br /> ��'" ontract n cer or ropose se o u n9 <br /> x�{.� H tt1 O ��' , c'ZJ <br /> ` �„�y ro e�t ddress <br /> gyH � ^ // G'� , �` AC/E <br /> n dy Jiscnpnon o tVor o e 'onw <br /> � �y � /.� {_' �.�Uv �� vGU' � <br /> H O tn <br /> I� <br /> w� <br /> i� � NOTE: MAC 296-�6-140 REOUIRES THAT PLANS FOR ELECTRICAL WORK AT EDUCATIONAL, INSTITUTIONAL OR HEALTH CARE FACILI <br /> BE APPROVED BY THE STATE OF WASHINGTON. APPLIGNTS MITH SUCH JOBS MUST SfiON THE STATE MPROVED PLANS BEFORE A <br /> CITY OF EVERETT PERMIT NILL BE ISSUED. <br /> ! '"' �' tlOTE: WIRING R� NON-DMELLINGS IS REOUIRED TO BE IN METAL RACENRYS. <br /> ' r— <br /> � � <br /> � I � I HEF[BY CERTIFV THAT 1 HAVE READ AND EXAMINEU THIS <br /> i 1� APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECL ALl <br /> '� PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS NPE OF <br /> �� _ WORK WILL BE COMPLETED WITH WHfl7HER SPECIFIED HEREIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> �+'�► AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR IOCAL LAW AEGULATING CONSTRUCTION OR THE � <br /> PEHFORMANCE OF CONSTFUCTION.THAT I AM AUTHORIZEO BY TIiE _/� ��� <br /> � OWNER OF THIS PROPEFTY TO PERFOFIM THE WORK FOR WHICH FEE 'S� <br /> �I� APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS lAW 1827 RCW AND 296200 WAC. <br /> � � <br /> � � X � � � �,�_ / <br /> n7 /�. � ,.- /,,� "i:� �.c � ���%�> <br /> �"Si�gnature�' Date <br /> . � i / ���p� <br /> J <br />