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APPLICA I iON FOk ELECTRICALMPERMIT <br />CITY OF EVERET! <br />BUILDING DIVISION <br />EV� n WA 98201 <br />PHONE: (A25)257-8810 <br />p,q)C (425)257-8857 <br />a�� ,A, ,m „�� �o J �f�u <br />PROJECT ADDRESS � <br />�t 0 o�i � W <br />Owner <br />SO�_d Es� <br />Tenant <br />�� <br />Mail Address <br />1�eJto' Co �1Nc, <br />Mail Address <br />� <br />2. <br />�vere <br />City <br />�I4Gt,-;�.���, i',o• oxao <br />Contraclor Mail Adtlress <br />OLCC-'[��Fa//oG <br />State License Number <br />" �rro kh� <br />propo ed Use ol Building <br />Description of Work ta Be Done: w�� h E <br />,,,a,,.. eJ�Y�rso S?�d <br />City <br />�� � <br />Ci�y <br />�:c e <br />� 9�a0 J <br />S�ate2ip <br />State2ip <br />A 98��9 <br />StatelZip <br />4� <br />asa•yo�o <br />Phone <br />Phone <br />yas- <br />ti aaaY7 <br />Pho�e <br />a� po0 — <br />Contract Price of Work <br />p,�o Co�, �,. <br />Contact Person (Plan Review) <br />C- /'e�,�/-"d eiro���1' i'or <br />APPROVED BY T�HE STATEROF WAS�HINGTONDUAPPL�ICANTS WITHISUCHIJO SGMUST oHOW THEUSTATE <br />EDUC�AT ONAL FACILBITIE�S AND IALL �HEALTH CARE FACILIITIESI PLANS IWSLLEBE REVIEW ED BY THIS OFFI �THER <br />NOTE: WIRING IN NON•DWELLINGS IS RE�UIRED TO BE IN RACEWP.YS, MC OR AC CABLE. <br />HANDICAPPED ACCESSIBILITY: ELECTRICAL AND COMMUNICATIONS SYSTEM PECEPTACLES ON WALLS <br />OF 5I NCHESSA60VE THE FLOOR.A�NAC 5120 SEC 3106(�2 TES OF TRAVEL SHALL BE MOUNTED A MINIhdUM <br />ENVIRONMENTAL AND OTHER CONTROL RECEPTACLES AND OTHER OPERABLE �EOUIPMENT WITHIN <br />RANGESIOF WAC 5E 20 S C�3N 6(b}4CE & FI AND NOOTTLES�S THAN 36LINCHES ABOV�EU HE �FLOOR IN THE REACH <br />1 HEREHY CEFTIFY iHAT 1 HAVE FEAD AND EXAMINED THIS APPLICATICN AND KNObV 7HE SAM1IE i0 BE TFUE ANO COFFECL ALL <br />PFOVISIONS OF W�YS AND CFDINANCES GOVEFNING THIS TYPE OF LVCFK IVILL EE COMPLETcD WHETHEF SPEGFIED HEnE1N OF <br />S�ATEOF uCALNLA�FFEGULiTIN�G CONOTF C'TION OF TNE PFFFOFh1ANCE OF CONS FUCTIDN.L THA FFO�V�?���THOFI ED BY�TNE <br />OWNER OF THIS PFOPEFTY TO PEFFOFhI L4E 6VOF.K FOF INHICH APFLICATICN IS hfAOE AND 1 COMPLY WIiH ThE SiA'E <br />CON7FACT096"4'1 Lv 19.2% Fj�.lj� �1 ND .^9o2C0 WAC. <br />Signature <br />ELECAP(REV 898i <br />� la 3/0 / <br />�a�e <br />� dIG� -C� 3 <br />FEE <br />