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RPPLI�A?'IUPI Ft�R ELECTRICAL NER�ilT <br /> F'q��� :iTvcF <br /> > � ev�r�#� <br /> C�rxi 9UILDING DEPARTtitENT , <br /> �'H5y� ?59-8810 <br /> H 7 r�+ . <br /> � y� <br /> / i <br /> v�H (/! C K f f'�U�/}-N �— ,j�� U!G�7 �I Ai: � <br /> h7 ~�] Z/ l �Af� 91�2�� � <br /> „�, z� nelrl r—�� Mail Addre.s Ity ip Ylione . . <br /> CO <br /> Hl7 <br /> � n C enanT—i Ma� ddress i ty ip hor�P Z yO 6 6 � — �/2�} (o � <br /> y-�j„C7n /�2:G_�S /�_c-�G �-'�/( /a$� SI SF S�t{Gf/(�s�J/S.Y [�J� ,�2[C_�SF243G� <br /> H � c ect�l r�c'TZ'ontractor Mat Adress �Cy—ZTp—�one tcense i <br /> H /1��.�i �i41 \ 1 <br /> r H y �oncracc nce o wor , ropose s uiTd�ng <br /> d N <br /> p C� 3 ::� l/- t. O t�? <3iF-%— /� <br /> � q r rF—oje�.t Address , <br /> C+7 <br /> t9 G7 <br /> yQ y �:rtption a Wark o e one: <br /> � O(J/+ /-1-� TFr- �i /� O �-.r't /' liiG.� � CiiL'� [� iTS <br /> {� ~ <br /> <.:�� <br /> NOTE: MAC 296-i6-140 REOU!RES TfiAT PL1N5 FOR ELECTRIUL YfOFK AT EDUGTIONAL, INSTITU710NA� OR HETLTH CARE FACILITIES <br /> g�'� BE MPROVE� BY THE STATE OF WASHINGTON. APPLIGNT.`� MITH SUCH JOBS HUST SHOM TNE STATE MPROVED PLANS BEFORE A <br /> � CITY OF EVF.RETT PERNIT WILI 8E ISSUED. - <br /> IIOTE: MIRINC IN NON-OWELlINGS IS REpUIRED TO BE IN NETAL RACEWAYS. <br /> 06� �d <br /> .d.„o <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AN�KNOW h!t SAME TO BE TRUE ANO COFRECT.ALL <br /> - �.� PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> WOFK WILL BE COMPLFTe�WITH WHETHER SPECIFIED HEf�EIN OR � <br /> NOT. TFIE GMNTING OF A PERMIT DOES NQT PHESUME TO GlVE <br /> y -� •.-0. AUTHORITY TO VIOLATE OR CAPICEL THE PflOVISIONS OF ANY ' <br /> _,,,, I OTHER STATE OR LOCAL LAW F.EGUTATING CONSTRUCTION Oq THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIIED BY THE .,` <br /> OWNEfl OF THIS PROPERTY TO PERFORM THE WOqK FOR WHICH FEE =�/i�� <br /> APPIICATION IS MADE AND I COMPLY WITH THE STATE �� <br /> CONTRACTOflS LAW 1827 RCW AND 29fi.200 WAC. <br /> .'a .� . <br /> X �� _ /��/ i�1- � <br /> �•, c- 2— .9L– l�L�– r+P 5,/ �.' � � <br /> // c-- <br /> Signature � � ate <br /> / <br /> � . L J � -1 <br /> _ , -� <br /> ; <br />