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i - <br /> APPL[CATION FOR CL�CTRICAL PGRM]T <br /> �rrv or•ev�iu.rr � <br /> ➢UILDItJG DIVISION <br /> 3200 CEDAR STREET <br /> GVEREfT,WA 98201 <br /> 259-88f0 <br /> d-N � / 1'r - - 77�1-/�ili.lir�/t/,i7.-G l�e.f�i-'- 6Y�t. S'F2o3�3.r�3-o/�y <br /> er � Ma�l Add:css City . ShtdZip Phone <br /> �lY/v�K <br /> Tcnant � - � Meil Add:ess City Stnidl.ip � Phonc <br /> Elxtriwl Conlractor Mail AdJrus City S1alc/Zip Phone Stale Licenu No. <br /> 4/� C'i�t/'-/n.-.C,9,��; _ <br /> Contract Price o(Work Proposed Use o(IIuilding <br /> � 7..r /4!h ��_ ��Pi 1' G <br /> ProjxtAddrcss <br /> Uucription o(Work lo Bc Dane:_�I// rr i/. /�. e <br /> NOTE:WAC 296-06d40 RGQUiRE:i 771AT PLANS FUR ELECTRICAL WORK AT LDUCATIONAL, W57'1'fUT10NAL OR <br /> HEALTFI CARE FACILTfIL•5 BE .43'PROVED IIY THE STATG OF WAS}11NGTON. MFLiCANTS WITH SUCH IOBS <br /> T1UST SHOW 7'HE STA7'E APFROV6D PLANS 6GPORL CITY OF EVEREf PERh11T WILL IIH ISSUF.D. <br /> NOTG:\VIRING IN NON-DWE[.LiNGS IS RL•QUIRED TO BG IN�iGI'ALLIC R\CEWAYS(MC ANIi AC, ARE CABLES, <br /> NOT RACGWAYS). <br /> 1 HGREUY CERTIFY 7HAT 1 HAVE READ AND EXAMINLD THIS APPLICATION AND KNO\V THG SAME TO DE 7RUG <br /> AND CORRGCP. ALL PROVIS10N5 OF LAWS AND ORDINANCGS GOVERNING THIS TYFL OP WORK WILL ➢C: <br /> COPIPLGTED WITH WFiETHER SPGCIFI[D NEREIN OR NOT.THE GRANTING OF A PERMfP DOHS NOT PRE•SQME <br /> TO GIVG AUTHORITY TO VIGLATE OR CANCHL THG PROVISIONS OP ANY OTHL-R STATE OR LOCAL LAW <br /> RGGULATING CONSTRUCTION OR THE P[RFORMANCE OF CONSTRUCI'ION. THAT 1 AAf AUTIIORIZED HY 'fHE <br /> ON'NLR OP THIS PNOPHRTY TO PGRFORM THE WORK FOR WHICH APPLICATION IS MADH AND I COMPLY WITH <br /> TI IG STATE CON7RACTORS LAW 18.27 RCW AND 296.200 WAC. <br /> \ <br /> ��C'���, � �n� !�' 7��I'/%� r�q�`�—_ <br /> Signnturc r Dalc <br /> de�.rr O�s,v» <br />