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�� � ,;� " APPLICATI,.�V FOR ELECTRICAL F �:RMIT <br /> C � H <br /> a � ti <br /> 4 <br /> �irv or <br /> �y ^ry everet# <br /> �F'' 'A f3UILDING DEPARTMENT <br /> V1 N <br /> yx 259-8810 <br /> [�1 O <br /> H l7 � �� <br /> p � �� ,�._�. �,y� AVr- <br /> � ts�$ � l � <br /> H` c❑' ��d' � � Lo�ll �' �, �^ � 7�i L �C 5,-,. '� l�v�, �,'-) �I.�J�.� �?i' 7- 53� �� <br /> Z M 3 (Tr er a� 7ddress lit�ip 'hone <br /> EyL <br /> r���y eInIant an� d ress Cy ip �one t a <br /> C] C1 fA /?C-\I , 'IOr� � I �G . 'I'�a� �'J q S f:-v �. -/� " �� � L �^� • C 'V <br /> Q � E ectr ca nntractor i� ress i��ty p hone ucnse <br /> H m S ✓ <br /> i-� -- ------- <br /> F30fA Cbn�ract � cc o o�— rl� opo.l�n n Iluilillnq <br /> 'ro�G�✓Y� n C� S � C..j �1 C�- <br /> �ddres5 <br /> �scr�ption o Work o e Done: <br /> sc� v '� � � s�s �/- • ) ��� L1 �� �� o� <br /> i� ��� _ <br /> `� — <br /> i ' <br /> I ��� <br /> , �I NOTE: WAC 296-46-140 dEOUIRES TII�T PLANS FUR ELECiRIiIAL WORK AT E�UUT1017AL� tI75TITUiIONAL Oft IIEALTII ChRE FACILITIES <br /> OE APPROVED �Y THE STATE OF WASIIINGTON. APPLICAlITS N'�T�� SUCII JO[f; HUST S!IOW T�IE ST�1E APPROVED PLAt75 9EFORE A <br /> CITY OF EVERETT PER111T WILL OE ISSUFD. <br /> i.�, IiOTE: WIRI1lG IN NON-DWELLR�GS IS REOUIRED TO OE IN IIEIF.I, '?ACf.WAY;. <br /> ��1 <br /> .� I HFREOY CEFTIFY THAT I HAVE HEAD AND EXA�dINED THIS <br /> 6 � ' APPLIC�TION�ND KNOW THE SAM[TO BE TRUE AIJ�COMECL PLL <br /> �► PROVISIONS OF LAWS AND ORDINANCES GOVE(i1JiNG TLIIS TYPE OF <br /> WOFIK WILL 8[ COMPLETEO WITH WHETHCR SPECI,'-IED HEREIN OR <br /> NOT. 111E GA���TING OF A PERh11T DOES NOT Pf1ESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL TFIE PROVISIONS OP APII' <br /> O1HER S7ATE Oti LOCAI LAW REGULATING COHSTtiUCTION GR THE <br /> "a s pERFORMANCE OF GONST;7UGTION. THAT 1 Ald AUTH0�28D BY 7H[ ' i � �- <br /> OWNER OF THIS PROPERTY TO PERFORId THE WORK fOfl WHlCH FF.E � __ <br /> � APPLICATIOtJ IS MADE AND I COIdPLY WITH TFIE STATE <br /> CONTRF G? fiS LAW 1027 RCW�NG 29G200 WAC. <br /> ' �L �/�� ��� � ' <br /> i� �^` / <br /> � X�L � �^>>i_ ��/�f U� L <br /> $ignature U,itc / <br /> l <br /> � i — i �' <br />