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' APPLICAT ��N FOR ELECTRICAL �'ERI�IT <br /> GI1Y Uf � <br /> everett <br /> BUILDING DEPARTMENT <br /> 259-8810 <br /> i <br /> HAR!"�O_If E /�SSOCIRT�S 86a5 EiknWlto� GJ�� Ew1cN YSZoA :'-!�i-160n <br /> vrner — ' Ma�� Addres City ip Phone <br /> rNF Mnr.1F�/ - 1( SE EUtneFi 4 uW EGac!� 9bZUb <br /> enant Mail ddress it ip Phone <br /> E i 61SSr���C Au� N �EA 9911�5 sa3-ysa, NELSOEi�-� C—. <br /> ectrica ontractor Mai ddress �ty ip hone icense ; <br /> 3,30-o OFFic�. <br /> _ontrac[ Price o work roposed se o ui d�ng <br /> /n�a�Mn�.� W� (surfe .x�� � <br /> �ro)ect Addres<_ � <br /> iscription af Work o e Oane: <br /> F���m�r 4 fr,��ar.rr r��n v�M���ri(� <br /> NOTE: WAC 296-46-140 REOUIRES THAT PLANS FUR ELECTRICAL WORK AT E�UCATIONAL, INSTITUTIONAL OR NEALTH CARE fACILITIES <br /> BE APPROVE� PY THE STATE OF WASHINGTON. APPLICAtITS 'NITH SUCH JOBS MUST SHOW THE STATE APPROVED PIANS BEFORE A <br /> CITY OF EVERETT PER111T WILL BE ISSUED. <br /> NOTE: 'NIRING IN NON-DWELLINGS IS REOUIREO � BE IN COHDUIT. <br /> I HEREBY CEFTIFY THAT I HAVE flEAD AND EXAMINED THIS <br /> APPL!CATION AND KNOW THE SAME TO BE TRUE AND COFRECT.�Ll <br /> PROVISIONS OF IAWS AND ORDINANCES GOVERNING THIS TlPE OF <br /> WOFK WILL BE COMPLETED WITH WHETHER SPECIFIED HEPEIN OR <br /> NOT. THE GRANTING OF A PEFiMIT OOES NOT PRESUME TO GIVE <br /> AUTHOAITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY � <br /> OTIIER STATE Of7 LnCt,l IAW RF.GULATING GONSTRUCTION OR THE <br /> PERFORMANGE OF CONS7"RUCTION.THAT�AM AUTHORIZED BY THE <br /> OWNER OF THIS PFOPERTY TO PERFOFiM THE WOfiK FOR WHICH FEE � �� <br /> APPLI(:ATION IS MADE AND I COMPLY WITH THE STATE <br /> CGNTRACTORS LAW 19.27 RCW AN�296.200 WAC. <br /> X lr-l. '� <br /> Signatu�•e Date <br /> 1��� "�l � <br /> �/" - - <br />