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� <br /> F:a1t ilA.11f� <br /> � L <br /> �j . e <br /> i <br /> �f�,'- . � � . . <br /> ' <br /> � AFPLICAT JN FOR ELECTRICAL r�ERMIT ��'�'`� � <br /> cin oF evmerr <br /> WILDING DIYISION <br /> ��� 3200 CmAR STREET <br /> EVtRETT, YA 98201 <br /> p�� 259-8810 <br /> H <br /> > v� � / <br /> � �� �i��-,?Gv f i���iSo�c/ G ' %<� �' �,C �t� /��z</ �1a'-�-/ 33 <br /> M .� /�' �� L f:Ti l�i � <br /> n ne.� ai ddress �ty —�tat� ip hone <br /> ° �� A-i ��"� ��; { <br /> enant ai ddress �ty�tate ip one ' <br /> � �C� �� <br /> H C ��"�'r»� <br /> � n�y ectrica ontractor ai ddress ity tate ip one tate icense o. <br /> H �g ��5�"� �� 1NLfG <br /> � <br /> �y yE's� ontracY r ce o ork �oposed tToT�iltling <br /> ty w y . <br /> H /�O7 ��v,ii <br /> tyry� P�rojec ddress ' <br /> O <br /> �q 7 ` / � /,�� <br /> tya� Discription of Work To Be Done: y/�� ��y �i /�/�7,1J �/7�2��`�"` r' ��/����,� <br /> O fA / �� <br /> /Q/,�/yr?�C(� � . <br /> � <br /> • - a <br /> �� <br /> ��� <br /> NOTE: WAC 296-46-140 REQUIRES THAT PLANS FOR ELECTRICAL WORK AT EDUCATIONAL, INSTITVTIONAL OR HEALTH CARE FACILITIES <br /> �, BE APPfiOVED BY THE STATE OF WASHINGTON. APPLICANTS WITH SULH JOBS MUST SHOW T4E STATE P.PPROVE� PLANS BEFORE A <br /> � �' ,CITY OF EVERETT PERMIT MILL BE ISSUED. , - <br /> w� <br /> NOTE: WIRING IN NON-DWELLINCS IS REOUIRED TO BE IN CONDUIT. <br /> � '� I HEREBY CERTIFY THAT I HAVE READ AND' EXAMINED THIS <br /> APPl1CAT70N AND KNOW THE SAME TO BE TRUE AND CORRECL ALL I <br /> PqOVISIONS OF UWS AND ORDINANCES GOVERNING 1HIS TYPE OF � <br /> ' WOFK WILL BE COMPLETED WITH WHE7HER SPECIFIED HEREIN OR <br /> (� NOL THE GRANTING OF R PERMIT DOES NOT PRESUME TO GIVE . � . <br /> AUTHORITY TO VIOLATE OH CANCEL THE PROYISIONS OF ANY �, <br /> OTHER STATE OR IOCAL UW FEGUL4TING CONSTRUCTION OR THE , � <br /> ��+ � PERFORMANC£OF CONSTHUCTION.THAT I AM AUTHOFIZED aY THE FEE `� �, �� l <br /> �I OWNEfl OF THIS PflOPERTY TO PERFORM THE WOFK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WtTH THE STATE <br /> CONTRACTORS lAW 18.27 RCW AND 96.200 WAC. <br /> � I_� q y <br /> �!-.`� � / �/ -/ .� <br /> Signatur Date <br /> I <br /> � <br /> � <br />