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APPLICATION FOR �LECTRICAL P�RMIT <br />CITY OF E•VERETT <br />BUILDING DNISION <br />3200 CEDAR STREEI' <br />FVERETT. WA 98201 <br />� <br />259-B8f0 <br />�y,zf4crr i.�.�--i-�:..c�c fk�r�sn,irc� �z�>,'F-rT <br />Owner Mail AdJress Ciry SmtdZip P6one <br />�UCT.CT7' /Ir-t:•1��UG /-�Tlfo�iPit'�/ <br />Twaut � �� � Mail Addtcu . Ci�y SmtdZip <br />a.rSrc- r .z �a6 <br />MN��r'E�tA'/j�l'T L4Ec:T �� /�o /?C,C �/`!Z A��Allkn�%� C�:d .`�ft5'3 g'7'%%K� <br />Electrical Conlnebr Afail Address City SlatdZip Phooe State License Na. <br />47�7 �„' <br />Contract Price of Work F�x, Proposed Use of Duilding <br />ILO�I {7G�c�� iT. �L� <br />Projat Addmss . <br />Dcxription of Work to De Done: N�u_+ F£-£-t�f�' S -T _.. 8 ir1n. E� 5 <br />__�yuarE 7cv�c��5 r tiG�r Fixr�ri�c .,vfuv ci� -T� tc.?...,�a<� � <br />NOTE: WAC 296+36-140 REQUIRES THAT PLANS FOR ELECTRICAL WORK AT EDUCATIONAL, INS7TfU170NAL OR <br />HEALTII CARE FACILITIGS AE APPROVED BY THE SYA7'E OF WASHINGTON. APPLICANTS WIfH SUCH JOBS <br />MUST SHOW THE STA7'E A3'PROVED PLANS BEFORE CITY OF EVL•HEC PEIU.fIT WILL �E ISSUED. <br />NOT[: WIRING IN NON•DWELLiNGS IS REQUIRED TO DE IN MEI'nLLIC RACEWAYS (MC AND AC, ARE CABLES, <br />NOT RACEWAYS). <br />I HEREBY CERTIFY 7HAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE 1RUE <br />AND CORREC'C. ALL PROVISIONS OF LAWS AND ORDWANCES GOVERNING THIS 7YPG OF WORK WILL BG <br />CO�IPLETED WII'FI WHEI'HER SPECIFILD IiERF.IN OR NOT. THL• GRAMING OF A PERMTT DOES NOT PRESUME <br />TO GIVE AUTHORITY TO VIOLATE OR CANCEL THG PROVISIONS OF ANY OTHER STATE OR LOCAL LAW <br />REGULATING CONSTRUCI'lON OR THE PLRFORh1ANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY'IHE <br />ON'NER OF THIS PROPERTY TO PERFORM THE WORK FOR WF31CH APPLICATION IS MADE AND I COMPLY WI7'H <br />7HE STATE CONTRACI'ORS LA\V 16.27 RCW AND 296.200 WAC. <br />a <br />Si;nawm <br />_,5_r3 F� y3 �s <br />Date <br />l I j <br />d�o.rr �isro» <br />