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^. r1 Ihr. L'ar I. r'1._bv.rNL.a'.. H ._.:.".L: aLVi ,nA S6014MA. 4.0. 1 .: a..r Lut, n: r. .. .� .•�YeLr..r :... <br />J l 7 S J �u �.S% • �� <br />APPLICATION FOR ELECTRICAL PERMIT <br />ancF� <br />evere## <br />BUILDING DEPARTMENT <br />?59•8810 <br />rh <br />ir�rvJr/ir <br />C+4� <br />.�r rn/nne <br />%yBeY .�H3 <br />`/G <br />Ss•c///< 04. <br />Unner <br />° <br />Ma <br />ee eu <br />ty <br />:p <br />_ <br />0none <br />TenantMail <br />Address <br />City <br />Zip <br />Phone <br />�'S <br />rz'/rc%•'c <br />R�'•/?or <br />/79 <br />+ <br />f</c , '9doS? <br />L(90 2.444-n/-AGeNiE-SYA-6N <br />c e-i etriea <br />ontractor <br />s <br />ress <br />ty <br />p <br />one i. cT si �— <br />�p oOD.oO <br />Used <br />Contract` —Pr <br />eTi o'iGor aT— <br />_ <br />ropose <br />se of Building <br />2g I Ca/ <br />Na <br />Fv rry t1l 4— <br />ro ect A <br />ooreat <br />/��.n .ti�i. <br />t, <br />�o /i+r/a./r <br />n<•r.� <br />/.'G��/.'.-: <br />c��i l��r.ie a Q.•,v/ <br />:aer pt <br />on oTNor o <br />ane: <br />NOTE: MAC 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 JOUS MUST SHOW THE STATE APPROVED PLANS BEFORE A <br />CITY OF EVERETT PERMIT WILL BE ISSUED. <br />MOTE: WIRING IN NON -DWELLINGS 15 REQUIRED TO BE IN METAL 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 10.27 RCW AND 296.200 WAG. <br />Signature Date <br />FEE <br />