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ELEC r�ICAL PERMIT AF��LICATION <br /> CITY OF E�'�RETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 <br /> � �� ��(�/'� <br /> PROJECT ADDRE S <br /> G�� - ��. � ���', It� <br /> Owner <br /> Maii Address City Stale/Zip Phone <br /> lVR'V� <br /> Tenant <br /> Mail Address CiN State/Zip Phone <br /> _!-(x��t �i �c��� /�30`/ s/'c t-�o N(� � �'� �nc� �,(� �:1�i �3Fe)�l3S—R��A' <br /> Electrical Contractor <br /> Mail Adtlress Gty State2ip Phone <br /> Tl�C�� ��`�q�K�° <br /> State License Number Contract Price of V/ork <br /> 5 ` I� Contact Person (Plan Review) <br /> Proposed Use ol8uilding <br /> i C O A`1/ �/' v <br /> Descriplion af Work to Bo Done: �-�w � � <br /> NOTE: PLANS FCR ELECTRICAL WORK AT EDUCATIONAL, FACILITIES UTILIZING STATE FUNDS MUST BE <br /> APPROVED BY THE STATE OF WASHINGTON. APPLICANTS WITH SUCH JOBS MUST SHOW THE STATE <br /> EDUCATIONAL FACILBIT ES AND ALL�HEALTH C E FACILITI SI PLA S WSLL BE REVAEW ED BY THIS OFFI OTHER <br /> NOTE: WIRING IN NON-DWELLINGS IS REOUIRED'f0 8E IN RACEWAYS, MC OR AC CABLE. <br /> HANDICAPPED ACCESSIBILITY: ELECTRICAL AND COMMUNICATIONS SYSTEM RECEPTACLES ON WALLS <br /> OF �I NCHESS BIOVE THECFLOOR.AWAC 5120 SEC 3 106(�2 TES OF TRAVEL SHALL BE MOUNTED A P�IINIMUM <br /> ENVIRONMENTAL AND OTHER CONTROL RECEPTACLES AND OTHER OPERABLE EOUIPMENT WITHIN <br /> RANGESIOF WAC SE 20 SEC.�3N 6(b)4CE 8 FI ANDROUT LES�S THAN 36LINCHES ABOV�E THE�F OOR IN THE REACH <br /> � HEREBY CERTIFY THAT 1 HAVE REAG AND =XAMIMED TH�S AFPLICATION AND KNOW TNE SAA1E TO BE 7FUE AND COAFECT. ALL <br /> PFOVISiONS OF LA WS AND ORDINANCES GOVEFNING TNIS TYPE OF WORK W1LL 8E COMPLETED WMETHER SFEpF1ED MEFEIN OR <br /> NOT THE GFANTING OF A PERAIIT DOES NOT PFESUh1E 70 GIVE AU7MORITY TO VICWTE OR CANCEL THE PROVIS70N5 OF ANY O7HER <br /> STATE OR LCCAL LAW REGULiTING CONSTAUCTION OR 7HE PERFORAfANCE OF CONSTF7C�10�'. THA71 Ah1 riUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO FERFOFM THE WOFK FOR WMICH APPLICATION IS 6fADE AND � COIdPLY IYITH 7HE STATE <br /> CCNTRACTORS LA l%78.27 RCW AND 296.:00 WAC. <br /> � - =� � ���LG� FEE <br /> ;�/ ; <br /> - . <br /> `� Slgnatum Data <br /> DEBIT& CREDIT CARDS ARE NOT ACCEPTED E �3��-OQ � <br />