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f° `r <br /> � APPLICATION FOR ELECTRICAL PERMIT <br /> � ��n o� �,��,T <br /> WIIDING OIVISION <br /> 3I00 [mAR STHEEf <br /> EVERETT� 11A 98301 <br /> 259•B8f0 <br /> � i2a 14y1 )�.f�-.��nn�2<'!��-u�-v���' (,Jn� �i9_C�'J 7��•��'•3 <br /> ner e � rms tCl y 5[ete Zip Phone <br /> � __ __ <br /> enant a eress ty ca[e ip one <br /> �c.2r. i�nJ 'r �c ��1 �f� �CJ/n ��/�OdiAL1'�li �l�/� `1S�/fa J���S'�i,j5`� �/.'Gt/L'C/GGP�L <br /> .Tectr ea on[roetor + resa ty [ate/Zip ��one ta e cenx o. <br /> ��e�J 'x �L/�7/ . )�,^7C//LC'L SI 1\ <br /> on[ract r ce o or �Proposed se o u d�ng <br /> �'�/ — � 5i !Jh'- 5 G`. �n� '/�/ t <br /> �o ect tlre�s ' <br /> iacrlPtlon of Xork To Be Done: ����G�/�7C;�� a[cJf,L �/ �iGE U✓ � <br /> :�OTE: WAC 296-46940 REOUIRES TNAT PLAHS FOR ELECTRIGL WORK �T EUVGTIOIUL, INSTITUTIONAL OR NEALTM GNE FAQ LITIES <br /> BE APPROVF.D 6Y THE STATE OF WASNINGTON. APPUCANTS MITH SUCN JOBS MUST SHOM THE SThTE APPROVED PLANS DEiORE A <br /> CITY Of EVERETT PERMII XIL� OE ISSUED. � <br /> 'lOTE: MIRINC IA FON-OWELLINGS IS REOUIPED TO fiE IN [ONDUIT. <br /> I NEREBY CE3TIFV THAT 1 MAVE READ AND� E%AMINEO THIS <br /> APPJCATIOV AND NNOW THE SAME TO BE TRUE ANO COFFECL ALL . <br /> PROVISIONS OF UWS AN�OflDINANCES GOVEFNING THIS TYPE OF <br /> KORK WILL BE COMPLETED WITX YMEIHER SPECIFIED HEREIN Ofl <br /> NOT.THE GRANiING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHOHIN TO VIOUTE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE O!7 LOCAL UW REGUUTNG WNSTRUCTION Ofi THE <br /> PERFOHMANCE OF CONSTRUCTON.TNAT I AM AUiHORIZED BV THE � <br /> OwNER OF THIS PROpERTY TO PERFORM THE WORK iOB wHICH FEE _y�1� <br /> pppLICATION IS MADE ANO I COMPLY WITN TI{E STATE <br /> CONTMCiORS UW 18.27 PCW AND 296.200 WAC. <br /> X ���1%�zk7� i��r �Z . <br /> ti <br /> Signatvre �ate <br /> �'_ ;;,f'C .1�� <br /> — — -� <br />