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APPLICATION FOR ELECTRICAL PERI�IIT <br /> CiTY OF EVERET'C ' <br /> BUII.DING DMSION C`y�,c� <br /> 7200 CEDAR STRE� <br /> EVE�E'IT. WA 98201 <br /> 259-8810 <br /> �.�,���� �o � m�, � 1 �u��d 9 �- ,���s� <br /> Qwuer Mail Addr:ss City Sta[e/Zip Phone <br /> Tenm`�� �� Mail Address . City S�ite/Zip • • Phone <br /> 4'rr� .uYl�aar�7g,�.5 S�S��- k�erft���5�a5�Ja �'mfl��rr��i <br /> � Electrical nttact Mail Addrass City ' Suie/Zip Phone State License o. m� <br /> ; ��� �� <br /> Contract Price of Work Proposed L'se oi t3uildiag <br /> �_� I�YI��►�-� �0 . ._r�� <br /> Proj�ct Address • :;;� <br /> � . <br /> Descriotiou of Work to Be Dane: �� l���P`l. .;:� <br /> �'4T <br /> i7- ' <br /> t NOTc:WAC 296rt6-140 REOUIRES TfiAT PLANS FOR eL�Ci'?1CAL �VORF; A"C EDUCATIONAL, INSTITVITONAL OR <br /> � HEAI.'IIi CARE FACII.ITIES BE APPROVED BY TELF STATE OF W.ASF�IJGTON. APPLICANTS WITH SUCH JOBS <br /> � MUST SHOW TI-IE STATE APPROVED PL,�.NS BEFORE C[TY OF EVEFL°.Z'PERASIT\VII.L BE ISSUED. <br /> s <br /> NOTE:WIFLING IN NON-DWELLINGS IS REQUIRED TO BE L�7 AtETAI.LIC R4CEWAYS (MC AND AC, ARE CABLES. <br /> NOT RACEWAYS). ° <br /> � I :-IEREBY CERTTFY THP.T I HAVE READ .WD E�C.4.'•fLV=D r-T?S :\?PLIC:\7TCN,�ND IG`70w TF�SAME TO BE TRJE <br /> ?.ND CORRECI'. ALL PROVISIONS OF LAWS AND ORDL4ANCES GOVER;lING THIS TYPE OF WORK WII.L BE <br /> COMPLETED WI'IH Wf�I'HER SPECIFIED H"tREi,^7 OR VOT. T^:� GcZ1NTI:iG OF A PERMIT DOES N01' PRESCfhiL• <br /> ! TO GIYE AUTHORfi'Y TO V10I.ATE OR CrWCEL THE PP.OVISIONS OF ANY OTFiER STATE OR LOCAL LAR' <br /> REGULATfNG CONSTRUCI'ION OR THE PERFOR.titANC5 OF CONSTFUCTION. TFiAT I Aht AURiORIZED BY THE <br /> OWNER OF THI� PROPERTY TO PERFOR.�i TF� WORS FOR `,YI?ICH :�PPLICATION IS hfADE AND I COMPLY WI'I'I: <br /> ' THE STATE CCNTRAGTORS LAW I8.27 RCW ?.ND 296.2C0 �VAC. , <br /> � <br /> X �� vi" / , Feey�Q.�� <br /> SigMature , � Date <br /> . U �a �y <br /> eleeePP r <br />