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APPLIC/?1 ION FOR ELECTRICAL PERMIT <br /> � [ITY Of [V[R[TT <br /> IIUIIDING UIVISIUN <br /> 3200 CmRR STPEEf <br /> EYEAEfT� MA 9B201 <br /> 259-8810 <br /> (-" �.'r!�r �r'��s.�.�,o /.3'�'Ti/u-K i rY <br /> bwner Ma� Address ity tatt �p �one <br /> enan[ Mat OtlrosT�s �ty tat< �p h�o�e <br /> /�'i75i�PcdAYf fr<<' . , h�r ✓9.' 'i �Y.li�'O Co'r�'. 3'�7 ^7�c i<v.�.–_/•i�:i[. <br /> iiectnca ontractTC or Mai �,OoresTd�—ZSty ta[e 8p—P�one'S aE-teTicens�o: <br /> ,[�f-5- fN'T <br /> Lontract nce o work roposea se a m aing <br /> 1� 7c: C h�:cN <br /> ro)e<t adress <br /> Discriptian of Work To Be Done: <br /> 1lOTE: WAC ]96-46-140 REOUIRES THRT PLANS FOR ELECTRICAL WOflK RT EOVCATIONAL, INSTITUTIONAL OR HEALTH CAftE FACILITIES <br /> �E PPPROVED BY THE STATE Of WASHINGTON. APPLICANTS WITH SUCH JODS MUiT SHOW THE SiA7E APPROVCD PLANS OEFORE A <br /> CITY OF EVERETT PERMIT WILL BE ISSUED. <br /> VOiE: WIftINC IN NON-�'NELLINGS IS REO�IFED TO BE IN CONOUIL . <br /> 1 HF'�EO� CEPTIFV THAT I MAVE READ AND� E%AMINE� THIS <br /> AP' LICP.iCN AND KNOW T11E SAME TO 0E TRl1E ANU CORRcCi ALL <br /> PRl'9SICN5 OF 14W5 AND OflDINqNCES GOVEflNING THIS iVPE OF <br /> WOR' WILL BE COMP�EfED WITH WHE7HER SPECIFIED HEPEIN CR <br /> N�„THE GPANTING OF A PEPlAIT OOES NOT PRESUME TO GI'!E <br /> nUTHORITV TO VIOLATE Ofl CANCEL THE PPOVI510�5 OF ANV <br /> OTNER STATE OR LOCAI LAW REGIIIATING CONSTHIICTION OR 7HE <br /> PERFORMANGE OF CONSTRUGTION.THAi I AM AUTHOF2E�9Y T11E �� ,J Li;J <br /> OWNER OF TMIS PROPERiY TO PERFORM THE WOF�(FOFi Y/HICII (EE <br /> APPLICATION IS MAOE ANO I COMPLY W�TH THE STATE — <br /> CONTRACTOFS lAW IB.27 RCW AND 296200 WAC. <br /> X �� j� � �_ y- �'r3 <br /> 5i9natvre Oate �'C;,, !'% <br /> _4 : , <br />