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, <br /> APPLICATION FOR�LECTRICAL P�RMIT <br /> CITY OF EVL•RLIT � <br /> IIUILDING DIVISION <br /> 3200 CEDAR STRL•ET <br /> EVERE7T,Wp 98201 <br /> 259-8810 <br /> � y�J(� J� /L)� / �� � <br /> �L'�. .��ii� !7 'wJ .�.i // � �i Z .� �r� �/ � � � �/J.i /� �lG�/ I71 � <br /> Own.t T1ml Addrecs Ciry StatdZip P600e <br /> Tconnt . .. . Mail Address . Ci�y StatdZiP � P6one <br /> / �1 /J1C [.LI�V/; <br /> j�J�(�;n>4 ./_'/.rc_ .?U l .i :�-:✓ih.� /��,—.1/ `'Hc%/ � �1 vf� l v7'"�c r= <br /> Elminal Cofitnclor Ma�l AdArcss Ciry 'SInM1Zip Phone SUte Licenu No. <br /> .S/� �� <br /> Contracl Price of Work Proposcd Uu of IIuilding <br /> /C.>,� '= /n:�,,..; � L- -� ,.._ /�. <br /> r�o�a�aaa.�s <br /> �'_�' � / / <br /> DrscriptionofWorkloHcDane:�i/ / T-�'-�ti�� �'-t � c. i � --.— %L<% PG J!�(. <br /> � NOTE:H'AC 296-06d40 REQUIRPS THAT PL/u4S�OR ELECCRICAL WORK AT EDUCA7'IONAL,INSTITUTIONAL OR <br /> IiEALTy CARE FACILiI'ILS AE APPROVED DY THE STATE OF WASHINGTON. APPLICANTS WITF; SUCH lOBS <br /> MUST SHOW 7'HB STA'fE MPROVLD PLANS DEFORG CITY OF EVEREI'pERMR'WILL BE ISSUED. <br /> NOTL:WIRING IN NON-DN'ELLINGS IS REQUIRED TO BE IN MEfALLiC RACEWAYS(MC ANll AC, ARE CABLES, <br /> NOT RACEWAYS). <br /> I HERG➢Y CERTIFY 7'HAT I HAVE READ AND EXAMINED THIS APPLiCAT(ON AND KNOW THL SAME TO BE TRUE <br /> AND CORRECT, qLL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK W1LL BG <br /> COAfPLHTED H7T11 WHEfHER SPECIFIGD HEREIN OR NOT.THE GRANTWG OF A PERMIT DOES NOT PAESUME <br /> TO GNE AUTHOBITI' TO VIOLA7'E OA CANCHL THE PROVISIONS OF ANY OTHER STA7'E OR LOCAL LqW <br /> REGULATWG CONSTRULTION OR 7HG PGRFORAIANCE OF CONSTRUCf70N. THAT 1 AM AUTHOWZGD BY 7HE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION 1S MADE AND 1 COMPLY WCfH <br /> Tf{E STATE CONTRACTORS LAW 18.27 RCW AND 296.200 WpC. <br /> � �!' � � �_ C- '- 3 - `' ; Fa 3 � �c�'G <br /> S,gnaturc ✓/ Dale <br /> �,�' _ <br /> ��«•rr�!sm» <br />