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5722 1ST DR W 2016-01-01 MF Import
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5722 1ST DR W 2016-01-01 MF Import
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Last modified
3/7/2017 8:00:43 PM
Creation date
3/7/2017 8:00:36 PM
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Template:
Address Document
Street Name
1ST DR W
Street Number
5722
Imported From Microfiche
Yes
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��3 <br /> A.PPLICATION FOR EL +'CTRICAL PERMIT <br /> CITY OF EVERETT <br /> SUILDING DMSION <br /> 3200 CEDAR STREET <br /> EVEREIT,WA 98201 <br /> 259�8810 <br /> �EtGt.T Q/e�s <br /> �'°ei Mail Addrcss City State/Zip Phone <br /> Twant Mail Address . Cit <br /> Y Smte/Zip Phone <br /> Elxtrical Contracror —�'�'3 <br /> Mail Address City State/Z�p Phooe Stete License No. <br /> /800.0o sFR <br /> Conhact Pnce of Work Proposed Uu of Bwlding <br /> S'/21 /Sr �R k/�3T <br /> Pro�xt Addrcss — <br /> Description of Work to Be Done: tJLld ,lfeu.6 ....w. n e�i�i i` <br /> NOTE:WpC 296-46-140 REQUIREg'I'HAT PLANS FOR ELECfRICAL WORK AT ELUCATIONAL, INS'ITI'UTIONAL OR <br /> HEALTH CARE FACII,ITIES BE ApPROVED BY TEIE STATL• nF WASHWGTON. ApPI ICANTS WiTH SUCH JOBS <br /> MUST SHOW TFIE STA'I'E APPROVED PLANS BEFORE CITY OF EVERET PERIv1IT V✓ILL BE ISSUED. <br /> N�TE:WIRING IN NON-DWELLII9GS IS REQUIRED TO BE IN METALLIC RACEWAYS (MC AND AC, ARE CABLES, <br /> NOT RACEWAYS). <br /> I HEREBY CERTIFY THAT J HAVIi REAII AND EXAMINED THIS APPLICATION AND KNOW Tf�SAME TO BE TRUE <br /> AND CORREC'(�, ALL PROVISIOivS OF LAWS qND ORDINAN('ES GOVERNING THIS TYPE OF WORK WII,L HL <br /> COMPLETED WITH WIiETHER SPF:CIFIED HEREIN OR NOT. THE GRANTWG O: A FERMIT DOES NOT PRESUME <br /> TO GNE AUTHORTI'Y TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL Lq'.y <br /> REGULATING CONSTRUCTION OR THE PERFORMANCE OF CnNSTRUI."I'ION. THAT I AM AUTHORIZED BY THE <br /> OWNER OF THiS PROPERTY TO PERFORM T'HE WORK FOR WHICH APPLICA'ITON IS MADE AND I COMPLY WITH <br /> THE STATE CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br /> X Yi!'il�� /�/11�L4;F. �S/q3 <br /> Signaturo ' '—��/ �-� Fee 3�ti,m <br /> Date <br /> u2�°�� <br /> d«erv�is�9» <br />
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