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�. -, <br /> APPLICATiON FOR ELECTRICAL t'ERMIT <br /> cirr oF �xerr <br /> BUILDINC DIVISION <br /> 3200 CFDAR STREET <br /> EVEItETT, IIA 98201 <br /> 259-8810 <br /> �l�hc� �{'� /yy/ol�J �d,Co! �//cr,r.� 9d� �1541-37s7 <br /> ner ai ddress ��ty tate ip Phone <br /> � enant a ress ty tate p one <br /> ectrD/D n�tor /3L/�adessA�t/UC .���ata� t�.f4 9 PO� $lphoo-99�/3 S�i DLD£lo fBJA <br /> � 5 F i2 <br /> ontract rice o or roposed se o ui ing <br /> s��9 a,�,� ��t�� -o� P��S p,� <br /> ro ect ress qGt I'o0 �i�'� �/7� <br /> Discription of Mor!: To Be Done: /V��✓ I'7�U`SC lC� � <br /> NOTE: MAC 296-46-140 REpUIRES THAT PUNS FOR ELECTRICAL WORK AT EDUCATIONAL, INSTITUTIONAL OR HEALTH CARE FACILITIES <br /> BE APPROVED BY THE STATE OF WASHINGTON. APPL�CANTS MITH SUCH JOBS MUST SHOW THE STATE APPROVED PLANS BEFORE A <br /> CITY OF EVERETT PERMIT WILL BE ISSUED. . � � <br /> NOTE: MIR�NG IN NON-DMELL�NGS IS REOUIRED TO BE IN CONDUIT. <br /> 1 HEREBY CEHTIFY THAT 1 HAVE READ AND' E%AMINED THIS <br /> ROVISIONS OF UWSMID OHDINANCES GOVERNING THRS TYPE OF <br /> WpRK WILL BE COMPLETED WfTH MMETHER SPECIFlED HEREIN OR <br /> NOT. THE GHANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOUTE OF CANCEL THE PROVISIONS OF ANY � <br /> OTHER STATE OR LOCAL UW REGUUTINCa CONSTRUCTIOFI OR 1HE �� <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHOFl�ZE�BY THE <br /> APPIICATIONISISRMADE ANOPERCOMPLY WIT�HKT ER STATE � <br /> CONTRACTORS LAW 18.27 RCW AND 296.200 V'1AC• <br /> X /������/� �•✓�'/at.l /a—.�-�lZ <br /> ^�+ oate <br /> Signature <br /> 39�a� <br />