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APPLICATION TOR�L�CTRICAL PERMIT <br /> CITY OF LVERETT � <br /> BUILDING DIVISION <br /> 3200 CL•DAR STRGET <br /> LVERFI'1',WA 98201 <br /> 259-8810 <br /> �re�� ��rLow 37ii i�^'�s� c��cxE�r 5�.1od 337-yo�y <br /> Owncr Mail Addrcss City . StatdZip Phone <br /> .UD,V,(r <br /> Tcnmt � � Mail Address t;iry SutdZip Phone <br /> N C���c�i�6g <br /> �'C.r� �/«nz�c. /y7o� �'rNa�u., �.N.- �/v� /I'IA�JV�///c <br /> Plxlriwl Cantnctor Mail Addrcss Cily StntdZip phone � SGte Licenu No. <br /> /�D°� ,L��S/l>L—"hJTiA L <br /> Contnct*ice o(Work prvFwsed Use af Huilding <br /> G8i5G oLu.na,� 1�,ci�� - t��Tr- <br /> r���ui naa��' <br /> Dcscription of Work to IIc Done:_///�/lG C�.��si/tis /n� 7�11J �✓��� � <br /> au�,o,c� Li�,o�Gr_ r Adi� 5' �tc,� �-to - <br /> NOTL:\VpC 296�46440 REQUIRES 1'HAT PLANS POR ELECfRICAL WORK AT EDUCA'HONAL,INSTITlTI70NAL OR <br /> HGALTI{ CARG PACILTf1ES UE APFROVED ➢Y 1'HL STA1'E OF WASHINGTON. APPLiCANTS WI77j SUCH IOBS <br /> MUST SHOW THH S'CATG MPROVED PLANS BEPORE CITY OF GVE•REl'PERMTT WILL 9E ISSUED. <br /> NOTG:WIRING iN NON•DWELLINGS IS RGQUIRGD TO BE IN METALLIC RACEWAYS(MC AND AC, ARE CAIiLES, <br /> NOY RACGWAYS). <br /> I 11GRL➢1'CERTIFY THAT 1 HAVE RLAD AND EXAMINGD THIS APPUCATION AND KNOW Tf{E SAME TJ SE TRUL• <br /> AND CORRECI'. ALL PROVISIONS OP LAWS AND ORDINANCES GOVERNING T1315 TYPE OF WORK WILL BE <br /> COMPLETGD WITH WHE7I;GR SPECIPIGD HEREIN OR NOT. 71iE GRANTING OF A PGRMIT DOFS NOT PRESUME <br /> TO GNE AUTHORITY TO VIOLATE OR CANCBL THG PROVISIONS OF ANY OTHER STATG OR LOCAL LAW <br /> REGULA7'ING CONSTRUCTION OR THG PLRPORhiANCE OF CONSTRUC710N. THAT I At.i AUT710RIZEU BY THE <br /> O\VNER OP T}115 PROPERTY TO PERFORDI THG WORK FOR N7iICH APPUCATION IS MADL AND I COAIPLY NTfH <br /> THG STATE CON7RACfORS LAW 18.27 RCW AND 296.200 WAC. <br /> � ���%e�-urJCf�l�fz 7-/9- y'3 r� �%,' <br /> Signalurc Date <br /> �liJY1 <br /> a«•vr��sro» <br />