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APPLICATION FOR ELECTRICAL PI RART <br />CITY OF EVERETT <br />BUILDING DIVISION <br />3200 CEDAR STREET <br />EVERETT, WA 98201 <br />2� <br />259.88f0 <br />"S' 40:7- /I0 es <br />Owner Mail Address City State/Lip Phone <br />Tenant Mail Address City Stale/Zip Phone <br />/k -3 <br />Electrical Contractor Mail Address City Sate/Zip Phone State License No. <br />_ /6k. go A16Aa AlduC <br />Contact Price of Work Pmposed Use of Building <br />&or Ko -:7e/ -SRD b4'. 4&5r <br />Pmjmt Address <br />Description of Work to Be Done: <br />NOTE: WAC 296A6-140 REQUIRES THAT PLANS FOR ELECTRICAL WORT: AT EDUCATIONAL, INSTITUTIONAL OR <br />HLALTH CARE FACILITIES BE APPROVED BY THE STATE OF WASHINGTON. APPLICANTS \VTTH SUCH JOBS <br />MUST SHOW THE STATE A°PROVED PLANS BEFORE CITY OF EVERET PERMIT WILL BE ISSUED. <br />NOTE: HIRING IN NON -DWELLINGS IS REQUIRED TO BE IN METALLIC RACEWAYS (MC AND AC, ARE CABLES, <br />NOT RACEWAYS). <br />1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE <br />AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE• <br />COMPLETED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME <br />TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW <br />REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH <br />THE STATE CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br />X <br />6�?�9.i Fee <br />Signature r Date <br />% de<•rP (315M) <br />