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�l � � <br /> ' APPLICATION FOR�L�CTRICAL P�RMIT <br /> CffY OF GVERL•TI' � <br /> ➢UILDING DIVlSION <br /> 3200 C[DAR STREEC <br /> L•VEREIT,\VA 9620I ' <br /> 259$8f0 <br /> ��C�7fli✓� ! �2 P�c f�s �;✓t2F�� !Z%° �i�'O3 s5S-3`�:_n <br /> Ownu Mail Add(ess Ciry S�tdZip P6oue <br /> Teoant � � ALilAddress City SWdZip Phone <br /> �`/L'1�L4/ <br /> Elatrial Contnc�or Mail AJd`ess City Sule/Zip PAone Slate Licenm No. <br /> CoNncl Price of Work Pmpoud Uu o(➢uilding <br /> Pmject Address . <br /> Dcscriplion of\4ork lo Be Done: �U.Y �-'l 2C_U� T j �`-O�C /� rn i f/1G`��✓�� �V e N <br /> /Iti J il ��� ! / N?�'� f/L <br /> NOTE:WAC 296A6-I40 REQUIRES'I'HpT PLANS FOR ELECfRICAL WORK pT EDUCATIONAL,INSTITUTIONAL OR <br /> HEALTH CARE FACILTTIES 8E APPROVED BY THE STA'['� OF WASHINGTON. APPLICANTS WITI� SUCH ]OBS <br /> �fUSf SHOW THL•STA7'G MPROVED PL1NS BEFORE CIl'Y OF GVERET PERMIT WILL BE ISSUED. <br /> NOTG:WIRING IN NON-DH'ELLINGS IS REQUIRED TO DE IN t�tETALLIC RACEWAYS(MC AND AC, ARE CA73LE5, <br /> NOT RACEWAYS). <br /> 1 IiEREOY CERTIFY TFiAT I HAVE READ AND EXAMINED T}t15 APPLICATION AND KNOW THE SAMG TO BE TRUE <br /> AND CORRECT. ALL PROV1510NS OF LAWS AND ORDINANCES GOVERNING 7HI5 TYPE OF WORK WILL BL <br /> C0�IPLERD WITH WHEI'HER SPECIFIED HEREIN OR NOT.71iG GRANi7NG OF A P[FU.S[T DOES NOT PRESUMG <br /> TO GIVG AUTIiORITY TO V10LATE OR CANCGL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW <br /> RGGULITING CONSTRUCTION OR TfiE PERFORMANCL OF ONSTRUCf70N. THAT 1 AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICA770N 1S MADE AND I CODIPLY WITH <br /> THE STATG CONTRACfORS LAW 18.27 RCW AND 296.200 WAC. <br /> � ; �� i� � <br /> r <br /> _�`—'� ,.�,l l,%d'ii1,/�� �;�5 i � F«l�J ct <br /> 'Signaluro �- Daie <br /> den ISN) <br />