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„ o <br /> ��f� APPLICATION I'OR 1;L�CTRICAL P�R117I1' <br /> / �103�s'a <br /> k� rra� <br /> CITI' OF EVE•RL•TT <br /> H <br /> 'c�H BL�iLDING DIVISION <br /> � H Vi :+.200 CL•DAR STRL-ET <br /> �-; �� LVERETI', WA 98201 <br /> H H 259-8810 <br /> K Q <br /> H 7� <br /> yVJ H / ' � � <br /> �O� �L�ci� 7Qa�..c.L Z3'1 F�i.` �rKite.tC G�/a. 25f3-�So3 <br /> O�wcr Tfail Address City State/Zip Phone <br /> H <br /> OH ” <br /> ��8 <br /> zy � Tenanl . �- � Mail Address City Slnte/Zip � Phone <br /> � yz /J Lm3 <br /> g�n H o '7k c. �i�.c. f�o. ��u �yZy ��c./�,.,.( fi�"a. 9BoB3 dJB9-Qrz� Lia cr�r �ioyC 3 <br /> n d y Eleclrical ContracWr Mnil Address City State/Zip Phone S4ate Liccnse No. <br /> � �y � O Srl� <br /> y p yy Contract Yrice of\�'ork Propos,;tl Use o(IIuiWing <br /> � SBZ2 /3T. �R. G/E5T _ <br /> Project Address <br /> � Descriptioo of\Vork to Be Done:�. fLtt�,..� �p:ity,e.-� <br /> � �� ' <br /> { `_ <br /> I � <br /> � NO'IE:WAC 296-46-140 REQUIRES T7iAT PLANS FOR ELECTRICAL NORR AT EDUCATIONAL, IN57'ITUTIONhL OR <br /> HEALTH CARE FACILIl'IES DF. APPROVED BY 'IHE STATE OF \VASF�INGTON. APPLICANTS WI7'H SUCIi JOBS <br /> �i �' � MUST SHOW T(-IE STATG APPROVL•D PLANS IIEPORL CITY OF LVL•RET PLRMIT WILL BE ISSUED. <br /> NOTG:WIRING IN NON-DWELLiNGS IS RGQUIR6D TO IIE IN METALLIC RACEIVAYS (A4C AND AC, ARE CABLES, <br /> NOT RACEWAYS). <br /> !'�1 I HER6DY CERTIFY THAT I HAVE READ AND EXAMINLD THIS APPL.ICATION AND KNOW TI{E SAML TO BE TRUL <br /> AND CORREC'f. ALL PROVIS]ONS OF LA1V5 AND ORDINANCES GOVERNING THIS TYPE OF WORK N'ILL DL <br /> WMPLETED MTH WHETHER SPEC;FIED HL•REIN OR NOT. THE GRANTING OF A PERMIT DOfiS NOT PRLSUAfE <br /> `� TO GIVL .4UTHORITY TO VIOLATE OR CANCEL THE PROVISIONS Or ANY OTHER STATE OR LOCAL LAN' <br /> REGULATING CONSTRUCTION OR THG PL•RFORMANCE OP CONSTRUCTION. THAT 1 A�f AUTHORIZ.LD B7' THG <br /> � � OWNER OF THIS PROPER7'Y TO PL•RFORTi THE R'ORK POR'�V131CH APPLICAI'ION iS TiADE AND i CODIPLY WITH <br /> THE STATE CONTRACTORS LA\V 18.27 RC1V AND 296.200\VAC. <br /> � �h pc <br /> ��ec�e-�t GF. ��/�£ � y/z5�q3 r� �t� <br /> Signnture . Date <br /> decnpp QlS19J) <br />