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APPLIC�ION FOR ELECTRICA"� `PERMIT <br />:I fY OF <br />ever�tt <br />3UILDING DEPARTMENT <br />?59-8810 <br />�� /J'v,� 97S �izoh.nrtz�s/r, �'i,% 9�z9G �1.`i,2- 3(� `�y <br />e�anC a� dress Cy ip hone <br />Rob's Elec r 4405 103rd <br />ectr aa antraetor ai ress � ty p one ieense <br />t,ontract r te o or ropose se o u� ng <br />p � � <br />� "I .�r .� �—.i/t('! " <br />ro eet dress <br />�//^e /J.GIL'- `I.C![S.c. <br />scr <br />C� /'�'l fJ <br />t10TE: 71AC 296-y6-110 REOUIRES THAT PLANS FOR ELECiRICAL IIORK AT EDUCATIONAL, INSTITUTIONAL OR HEALTH CARE FACILITIES <br />BE APPROVED BY THE STATE OF XASHINGTON. APPLICANTS MITH SUCH JOBS MUST Sf10N THE STATE APPROVED PLANS BEfORE A <br />CITY OF EYERETT PERMIT NILL BE ISSUED. <br />IIOTE: MIRINC IN NON-DtlELLINGS IS REpUIRED TO OE IN METAL RACEMAYS. <br />1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING TFIIS 7YPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTINQ OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHOR�TY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL UW REGUTATING CONSTRUCTION OR THE <br />PERFOHMANCE OF CONSTRUCTION. THAT 1 AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND � COMPLY WITH THE STATE <br />CONTRACTORS LAW iB27 RCW AND 296.200 WAC. � <br />�. . � �� _, - �� <br />,= i -t,,_r,. �_�-c) =< � ` . <br />� Signaturo Date <br />FEE <br />