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A.PPLICATION FOR ELECTRICAL PERMIT <br />CITY OF EVERETT <br />BUILDING DIVISION <br />3200 CEDAlt STREET <br />EVERETT, WA 98201 <br />L',;'. 'f'� <br />'� ��:�c� <br />i4NDefSDN �� o+ri0 �v, nb✓/<<�rCc� C�(i0 EVrI•rii itivYJ`�� '$3- 575.3 <br />Owner Mail Address City State/Zip P6one <br />Teuant <br />Mail Address <br />City SL�te/Zip � Phone <br />iY7o� .•,,v,i�s�,a.c. C�� � C, <br />G�>�rCerv E����'c �,c. �, b� �S8 ,O�/ I/4 �/ G+i,Q, %/ ;' 2� s%a'8�g'%%� Gfi�n E/U3S0 S <br />Electncal Contractor Mail Address City State/Zip Phooe State License No. <br />960 '' _ �°s��e,u-� <br />Contract Price of Work Proposecl Use of Buildiag <br />�U/D G�, /J7i'lC�l.re(� i�lc� <br />Project Address <br />Description of Work to Be Done: fi'�OD �1 pG�o�C X Rec 7A��t c / �AQD�P 7A�U rn Sa.�7e�i a3 <br />Tn Fx/S7'/N9 flrr��,4eG . /%%^yZ ^ `YirT�Ny �u�le�Ar.�c�rS <br />NOTE: V�'AC 296-46-140 REQUIItES THAT PLANS POR ELECTRICAL 1'VORK AT EDUCATIONAL, INSTITUTIONAL OR <br />HEALTH CARE FACILTTIES BF. APPROVED BY THE STATE OF WASHINGTON. APPLICANTS WffH SUCH IOBS <br />MUST SHOW THE STATE AYPROVED PLANS BEFORE CITY OF EVERET PERMIT WILL BE ISSUED. <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO BE W METALLIC RACEWAYS (MC AND AC, ARE CABLES, <br />NOT RACEWAYS). <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE <br />AND CORRECT, ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL HE <br />COMPLETED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMTT DOES NOT PRESUME <br />TO GNE AUTHORITY TO VIOLATE OR CANCEL 7'HE PROVISIONS OF ANY OTHER STATE OR LOCAC. LAW <br />REGULATING CONSTRUCTION OR 'fHE PERFOELMANCE OF CONSTRUCTION. TEIAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WIiICH AF'PLICATION IS MADE AND I COMPLY WITH <br />THE STATE CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br />��i �� j <br />X--''�'E"��- .��i��s� �. <br />Signature <br />Dale <br />� �0 <br />Fee�_ <br />eleeopp (!IS/93) <br />