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H(]� <br />D�H <br />��� <br />��� <br />Hy <br />Z <br />o�e <br />��8 <br />QY (] <br />ry� <br />� <br />g5�� <br />HO� <br />IL� <br />�� <br />APPLIGATIL��I FOR ELECTRICAL i �RMIT <br />•rv cF <br />'_VQY2�� <br />;UILDING DEPARTbiENT <br />i59•8810 <br />I�A����N �JeNo icvto � 3G/k '� 4� ile�e FyE Frf 9.f''� � �S',2�ZuY 9 -- <br />.rinnv Ma Adaress ty � none . . <br />�anant a ddrees ty ip hone � <br />c tetr ca ntraetor a Cdress ty p hone icensa f <br />S�l'� <br />roncr�et �iae o Nor , ropose se o uiTdinq <br />3Ll�- /'ocKe�r��erC <br />�o]eet'—C+ ddreas <br />T � r t 'ic liEr1 c�(' <br />� �acnpe an o Work o e ne: <br />NOTE: MAC 296-46-140 REOVIRES THAT PLANS FOR ELECiRIGL NORK AT E�lIGT10NAL, INSTITUTIONAL OR HEALTH GRE FACILITIES <br />BE MPROVED BY THE STATE OF MASHINGTON. APPLIGlNTS NITH SUCH JOBS MUST SHOX THE STATE APPROVED PWIS BEFORE A <br />CITY OF EVERETT PFStt11T WILL BE ISSUED. <br />HOTE: MIRINC IN NON-DYfELLINCS IS REOUIRED TO BE �N METAL MCEXAYS. <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPUCATION AND 1(NOW 7HE SAME TO BE TRUE AND COHRECT. AlL <br />��a ,�� PfiOV�SIONS OF UWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLEfEO WITH WHETHEA SPECIFlED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOUTE OR CANCEL THE PROVISIONS OF ANY <br />,5,� OTHER STATE Ofi IOCAL UW REGULATING CONSTRUCTION OR THE <br />L PERFOHMANCE OF CONSTflUCT10N. THAT I AM AUiNORIZED BY THE <br />OWNER OF THIS PROPEHTY TO PEiiFORM THE WOFK FOR WHICH <br />�- APPUCATION IS MADE AND I COMPLY� WITH THE STATE <br />CONTRACTOflS LAW 1B.27 flCW AND 2962W WAC. <br />� i <br />� �f 7 <br />_�)4 �%F.-'I��t.� � ����� � <br />Signature • Date <br />FEE �5 <br />� �� <br />�1 � <br />, � <br />