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crn• or avE��-r <br />BUILDING DIVISION <br />3200 CEDAR STREET <br />EVEREIT, WA 98201 <br />AE'PLICATION FOR L�rCTRICAL P�IZMIT <br />(� <br />,��� � <br />� � � j [ ) <br />25d-8810 <br />PORT e��VEQSTT �✓'GRE� L✓LI- ��'s' �n!-j'' � <br />O�wer Mail Address City State/Zip Phone <br />Tenant <br />RrrrA L� 5N <br />Elutrical Contractor <br />Mail Address <br />�� / o� <br />Contract Price of Work <br />� <br />City <br />��.3�- r��t2��✓� r�EJ oRi✓�' <br />Project Address <br />City State/Zip <br />Tise of Building <br />Phoue <br />State License�7 o <br />RM/�i.S'.C�o$SOF <br />Descriplion of Work to Be Done: �!J /y' -�j .fiQ.�/IG�� �j %�J✓ J../�¢ T-S <br />NOTE: WAC 296-56-140 RLQUIRES THAT PLANS FOR ELECTRICAL WORK AT EDUCATIONAI INSTI'fUTIONAL OR <br />HEALTH CARE FACILITIES AE APPROVED BY THE STATL OF WASHINGTON. APFLICANTS WITH SUCA IOBS <br />MUST SHOW Tf� STA7�E APPROVED PLANS BEFORE CITY OF EVERET PERMIT WILL HE ISSUED. <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRLD TO BE IN METALLiC RACEWAYS (MC AND AC, ARE CABLES, <br />NOT RACEWAYS). <br />I HLF.EBY CERTIFY THAT I HAVP READ AND EXAI�4INED THIS APPLICATTON AND KNOW THE SAME TO BE TRUE <br />AND CORRECT, pLL PROVISIONS OF LA\VS AND ORDINANCES GOVL'RNING THIS TYPE OF WORK WILL EL <br />COMPLETED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESLJME <br />TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW <br />REGULATING CONS7'RUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT i AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TC PERFORM THE WO?tK FOR 11'HICH APPLICATI�N IS MADE AND I COMPLY WITH <br />THE STATE CONIRACTORS LAW 18.27 RCW AND 296.200 �VAC. <br />/;i=:. � � ; <br />7 !!.� <br />r•�: %� <br />ciccnpp (!/$/oT. <br />