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� � � <br /> � � x <br /> � � H APPLICA i �ON FOR ELECTRICAL PERMIT <br /> K � <br /> H �1 <br /> y �H CITY OF EVEREff <br /> r OUIIDINC DIVISION <br /> x "Z '3 3200 CmAR STREET <br /> [�7 y tG+7 EVE7tEf7, XA 98201 <br /> � �g zss-sa,o <br /> � c� / / / <br /> H� � /9'u��/�F' ���1 G✓'cc�r� � I ! � ��'� ', i�'��' l ��Se— ���� y <br /> zH� � <br /> y y wne Mail Address ity $tate ip Phone <br /> t� z <br /> HH <br /> gN <br /> H <br /> O l'y Vi enant Mai ddress ity tate ip hane <br /> ��� {� �— � <br /> H O Cn ec rical ontractor Mai ddress ity tate Zip hone tate icense o. <br /> � ��SG��C ,� <br /> ontract Price o Work Proposed Use o Building <br /> � �,^^� <br /> � /�� . . <br /> ro,7ect Ad r^ss <br /> Discription of Work Ta Be Done: p`—�L"�� /� L� <�-ji✓`� i C-P _ <br /> ' � <br /> '�' <br /> I I NOTE: WAC 296-46-740 RcOUIRES THAT PLANS FOR ELECTRICAL WORK AT EDUCATIONAL� INSTITUTIONAL OR HEALTH CARE FACILITIES <br /> BE APPROVE� BY THE STATE OF WASHINGTON. APPLICANTS WITH SUCH JO85 MUST SHOW THE STATE APPROVED PLANS BEFORE A <br /> '�I CITY OF EVERETT PERMIT WILL BE ISSUED. . <br /> '`' NOTE: WIRINC IN NON-DWELLINGS IS REpUIRED TO BE �N CONDUIT. <br /> 'c�' i HEflEBY CERTIFY THAT 1 HAVE REAO AND� EXAMINED THIS <br /> �� APPLICATION AND KNOW THE SAME TO BE TRUE AND COFflECT.ALL <br /> _ PflOVISiONS OF LAWS AND OFDINANCES GOVERNING THIS TYPE OF <br /> WORK Wlll BE COMPLETED WITH WHETHEH SPECIfIED HEREIN Ofl <br /> ..I NOT. THE GRANTING OF A PERMIT DOES NOT PFESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY � <br /> �I OTHER STATE OR LOCAL LAW REGU:ATING CONSTflUCTION OR THE L�U <br /> � PERFOFMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY iHE <br /> ' OWNEA OF THIS PROPERIY TO PERFOFM THE WOflK FOR WHICH FEE � <br /> APPIICATION IS MADE AND 1 COMPLY WITH THE STATE <br /> '=� CONTRACTOFS IAW 1827 RCW AND 296.200 WAC. <br /> �-e X �i,,-w l/`i���-' j.- 7 -, -ri <br /> SignaCure Oate � <br /> ^ �\ / <br /> \ I <br /> % V <br />