Laserfiche WebLink
APPLICATION FOR ELECTRICAL PE, tMIT <br />'I TY CF <br />evere#-t <br />BUILDING DEPARTMENT <br />259.8810 <br />II <br />ma <br />Urncr Mail Address City Zip Phone <br />QIICIANL°Ly)AKjfjr_-r (�9 MAVLs9k L-/w/- - r_y- 93zo1 -. zsy-3�9i; <br />enanc at At sTT s Ct t'—y—Zip hone <br />cIcctrical Contractor Mail Address City Zip Phone License # <br />41 �c� lJT I LJ C- 3 o I S K�onf+r r� I=v 9 E3? zS2-Y99i Iy��llV / . 5/7 4 C/� <br />Lon[ract n ce Nor Proposed se o utl dt ng <br />Loz� ��1�u�s�Y L/1ti1r= <br />Jiscription of Work o Oc Done: D /TAU <br />Al, T__ z o o A ti1/� S��2Vi�✓ G'j ove N✓ 4� /!-,i��T� E/ <br />g/= X/;e-1 44±7-zz ,lw- <br />NOTE: 'WAC 296-46-140 REQUIRES THAT PLANS FOR ELECTRICAL WORK AT EDUCATIONAL, INSTITUTIONAL OR HEALTH CARE FACILITIES <br />BE APPROVED BY THE STATE OF WASHINGTON. APPLICANTS WITH SUCH JOBS MUST SHOW THE STATE APPROVED PLANS BEFORE A <br />CITY OF EVERETT PERMIT WILL BE ISSUED. <br />NOTE: WIRING III NON-OWELLIMGS IS REQUIRED TO BE IN 14ETAL RACEWAYS. <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br />Sig ature Date <br />yd <br />U <br />FEE S J n <br />