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CIT'Y OF EVERE'I'r <br />BUILDING DNISION <br />3200 CEDAR STREET <br />E��TT. WA 9R201 <br />Owner <br />Tenant <br />Electrical Contractor <br />Contract Price of Work <br />Project Address <br />r-. <br />APPLICATION FOR F,LECTRICAI, pF�T <br />3�i'�4 <br />Mail Addrcss <br />Mail Address <br />� <br />Mail Addmss <br />D�scription of Work to Be Done: <br />City <br />25g-B8f0 <br />t,�/.� �d'�o/ ZS2_iFF�, . <br />State/Zip <br />Phone <br />City State/Zip <br />Phone <br />�iiE • �60ET! �.M- � zs+11i6 ♦ <br />City State/ZiP Pb�/ E 44NJ�t�� <br />State Liceuse No <br />Proposed Use of Building <br />NOTE: WAC 296-46-140 REQLTIi�g'�AT PLqNS FOR ELECI'R1C,es, WOg� AT $DUCATlONAL, INS <br />�'°�-TH CARE FACfLIT'(Eg gg pppROVED BY T'I� STATE OF WASHINGTON. <br />MUST SHOW THE STATE qppRpygp p�S BEFORE CITy OF E VHRE�' pg��. �� BE ISSUED. T��ONAL OR <br />`'�NTS WITH SUCH JOBS <br />NOTE: W�NG IN NON-DWgLLINGS IS R&QUIRfiD TO BE IAI ME'�'qI,�C g,yCEWqyg <br />NOT RqCEWAYS). (MC qND AC, <br />ARE CABLES, <br />I��BY CERTIFY THqT 1 HAVE RfiqD ,yl� EX,qMINED q'�S ppPLdCATION ,�.7D �OW <br />AND CO��, q� pROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS Typg pg q,0� BE TRUE <br />COMPLETEp y�JTg �.j.�R SPECIFIED IIEItEIN OR NOT. TT;E G <br />TO GNE AUTIipR�7�7• TO VIOLATE OR CANCEL THH pROVISIONS40 ING OF A PERM71' DOES NOT P� �E <br />REGULq'MNG CONSTRUCTION OR THE PERFOkM,yNCE OF CUNSTRUCI70N. THAT I AM q�pg�ZED By 'I'}Ig <br />OWNER OF TFIIg pROPERTY TO PE(�pRM �E W�� FOR WH1CH APPLIC T'A �ON ISHMAIJgATE OR LOCqL LqW <br />'1'iiE STATE CONT'RqC7'ORS LAW 18.27 RCW ,qND 296.200 WAC. �1ND I COMPLY WI'I'H <br />X <br />Signaturo <br />Date <br />. F� 35 <br />, � �?,I2� �� <br />c�ocarr (?�5�9J• <br />