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1 �,... <br /> � <br /> � �� <br /> � � x <br /> 9Hcn <br /> H <br /> y H <br /> b H� APPLICATIV�d FOR ELE�TRICAL FLRMIT <br /> fp H <br /> L�7 0 � <br /> Q H � <br /> irv cr <br /> ~" � evere#�t <br /> z i-+ � 3UIlDIP1G DEPARTNIEIJT ', <br /> r y z "�59�E1610 <br /> �yHH <br /> O �n F"� - L.�4CSoLTFHf�GE <br /> o G p� C r5���.� <br /> �� � E�E�� �,�..�� ,r�,�o,ti� �n �.�� s8�� 2S9 - .so7� <br /> HON l;�'�ncr 11ai1 Addr^ss City tip Nhonc <br /> �.c�a� 292. �9A��T,En/�i.t� 2.�io �o•�,s.��� `1��� <br /> Tenan[ 14a� Address City ip Nhone Q��2,-Q//� � <br /> l-�,v�rF..o �i-F�2rG_��'�-��, S�o� So 2�Ay� r�E,�,� �slvs C/.t�/7�ECG/96/`/� I <br /> e(cctnca l.ontractor tlail AddFn,s ��ty �P <br /> Phonc—Gcensr d '� <br /> .�.5-Gb% � /7F_�5ii,✓; /�•4.0 ��'F/cE � <br /> i.an[ract ritc ot V9or roposed 5c o��iu�T��ng ', <br /> 5.m�r .�s /��vF �, <br /> I'roj�Cc[AtldresS � <br /> %F.v� .T/!P�dEr7F.vT /t�,c�./�/u ifTs r/���£— � <br /> �.iiscription uf ��Vork lo !ie Uon�: <br /> j��� � _ � <br /> +�s <br /> i <br /> � � i <br /> I ��� <br /> �.�� <br /> ❑OTE: 'HAC 296-4G-140 REOUIRES THAT PLAGS FOR F.LECIRICAL WORK AT [OUCATIOIIAL, ItlSiITUTIOflAL OR HEALTN CARE FACILITIES ' <br /> �` BE AFPROVED �Y THE STAIE OF WASIIINGTOt7. APPLICANTS WITH SUC11 J0�5 MUST SIIO'A THE STATE APPROVE� PLANS BEFORE A <br /> I, �`�� ' CITY OF EVERETT PERMIT 'NILL UE ISSUED. <br /> IIDTE: '�91RItIG It! t1017-�WELUtIGS IS REOUIRcD TO OF RI h1ETAL RACEIVAYS. �� <br /> +�r� <br /> I IIEREDY CERTIFY THAT I HAVE F1EA0 AND E%AMINED THIS <br /> APPUCATIOPI AMD KNOW THE S�ME TO�E TfiUE AND CORRECT.ALL <br /> � pFiOV1510NS OF LAWS AM�ORUINANCES GOVERNIPIG THIS NPE OF <br /> '� M ' ' VlORK WILL BE COSIPLETEO WITH VlHETHEFI SPECIFIED HEREIN OR <br /> r PIOT. TkIE GPAMTING OF A PERMIT OOES NOT PR[SUIdE TO GIVE <br /> � AUTHORITY TO VIOLATE 0f7 CANCEL THE PROVISIQNS OF ANY <br /> I �� OTHER STATE OR LOCAL U1W REGULATIMG CONSTfiUCT10N OR THE <br /> ,` PEFiFORMANCE OF CONSTf7UCTION. Tf IAT I A1d AUif IOR12ED BY THF, f-��j �-v; <br /> ��� ,p ! pWMER OF TIi15 PROPE(�TV TO PERPOFiId THE WOfI{C FOR WHICH FEE <br /> �PPUCATION IS 1dADE AND I COMPLY WITII TIIE STATE <br /> GONTfiACTqRS LAW 1027 RCW ANO 29G200 VYAC. <br /> X r � <br /> -t���'�� z�i 3-�z. <br /> $ignaturc OaCc <br /> ,_! �' ;/ � � <br />