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APPLICATION FOR ELECTRICAL PEI'.IYIIT <br /> CCfY OF EVER.ETI' <br /> BUILDING DMSION <br /> 320Q CEDAR STREET <br /> EVEcZETT, WA9820L 259-8870 <br /> '.��.1 �Ih , �on I`�.�� �a� C�u-e �t ��Q�lr (.eb. 4��1 �5q-.5%�� <br /> Owoa �—Mail Addrss Gt� Stace/Zip Phone <br /> Ten�� Q . Mail Address . . Gty Sute/Zip Phooe <br /> �wl n nn n�1/�� i I�n��l.d�- �� �C� �r)� I (�-L��` C��I(�l� C.� ���� <br /> Eiectrical C ntractor Mail Address C;ty ' Sute/Zip Phone State Licease No. <br /> ►95 �' ��� <br /> Coatract Pnce of Work Proposed lise ui 3uilding <br /> � ��� �,� C�re <br /> pra;ece Adc'ress <br /> Descrioeioa of�Vork to Be Dooe: C- — <br /> �� a� - ��� �_..� �_�__.����.�,p <br /> YOTc:1VAC ?96�16-140 REOUIRES '['I-I.•�T PL.��'S r02 eL�.IC.�L �'%ORF: .�T EDUCATIONAI., INSTITUn�NA1- OR <br /> i-�ALTH CARE FACQ.ITCES BE AP°ROVED BY T?C STATE OF «'ASF�-L`7GTON. APPLICAM'S WII'H SUCH JOBS � <br /> 1SUST SHO�V'I'HE STAic ?.PPROVED PLA2JS BE'rORE CfTY OF EVE�T PERAfIT�VII.L BE ISSUED. <br /> NOTE:WIItING IN NON-DWELLINGS IS R�.QUiRED TO BE �� �.tETAI.LIC R�CEIVAYS (�fC AND AC, .4RE CABLES.} <br /> NOT cZACEWAYS). <br /> I !-�P,E9Y C=_RTIFY THAT I H?.� RE,�D ��ND �`c.�.�•iLVEJ 'I='?S :�.?PL?C:ITICN•��(D fCT70�V THE SA,VfE TO BE TRU; <br /> ,aND CORRECI'. ALL PROVISIONS OF L\WS AND ORDLtiA;VC=S GO`%E?,`7ING TH1S TYPE OF WORK WII-L BE <br /> COMPLETED ��CH WFTEI-FIER SPECIF[ED [-C?.Ei.*I OR VOT. T^:n G�.L`rTI\G OF �1 PERASIT DOES NOT Yt.ESUME <br /> TO GNE AUTHORITY TO V10LATE OR CAIJCEL TF{$ pRpVISIONS OF ANY OTFiER STATE OR LOCr`.L LA�ti' <br /> REGUL4TING CONS7'FtUCT70N OR THE PERFOR'.[A,^7CG OF CONSTFUCi']ON. TEL4T I Aht AUri-IORIZED BY TI-� <br /> OWNER OF TI-II� PROPERTY TO PERFOR`t T'rIt WORK FOR 'hl?Ii:H .\°PLICATION IS MA:-:E AND I COhiPLY WI'IT: <br /> i�IE SI'ATE CONTRAGTORS L:�W IS.27 RC1'� AND 296.'_'CO WAC. � <br /> � ��� ; � �� , <br /> � F��.� <br /> Sieriature Datc <br /> . � I <br /> d<<npi� C <br />