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��� <br />m�x <br />Q H <br />�HN <br />�3�H <br />K c� <br />H x1 <br />050 <br />'i1 h7 '� <br />VJ H <br />x <br />o�d <br />�^�g <br />M,V n <br />�H� <br />z <br />Hy <br />Sy <br />H <br />C❑� qC7 [� <br />C+1 n M <br />HOy <br />� <br />� <br />L� <br />- <br />, �� � <br />I ��� <br />v �1 <br />CITY OP EVEtSTT <br />BUILDING DMS10N <br />3200 CEDAR STREET <br />L• VERETT, 1VA 98201 <br />APPLICA.TION I'Ol: �L�CTRICr1L PLlu\�fIT <br />�EGEcr •�/��5 <br />Owner Mail Address <br />Tenaot <br />E•Icctrical Contreclor <br />/ $eo, o0 <br />Contract Price of Nork <br />Address <br />Tfail Address <br />59rz ��fa �iPi✓E k/Esr <br />Projat Address <br />Description of Work to Be Done: <br />c��y sc�c�iz�� <br />City Stn(elZip <br />��� <br />City 3mlrlZip Pho❑c <br />.UEu� KES/DE,c.e6 <br />Pmposed Usc of Duilding <br />259-88i0 <br />rno�� <br />Phooc <br />State Liccnsc No. . <br />NOTE: \VAC 296-46-140 REQUIFLES THAT PLANS FOR ELECTRICAL �VORK AT EDUCATIONAL, INSTIT[ITIONAL OR <br />IiEALTTi CARE FACILITIES IIE APPROVED IIY�THE�STATE OF WASHINGTON. AI'PLICAN'I'S 1VITH SUCH JOIIS <br />MUS'C SHOW TI-IE STATE APPROVLD PLANS BEFORE CfTY OP EVL•RET PLRMIT WII.L IIE ISSUED. <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO BE IN rfLTALLIC RACHWAYS (MC AND AC, ARE CABLES, <br />NOT RACL•\YAYS). <br />I HE•REDY CERTIFY'fFIAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAA1G TO IIE TRUE <br />AND CORREGT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORIi WILL IIL <br />COMPLETED 1VfIH WFiETHL-R SPECIFIED IIL-RLIN OR NOT. THE GRAN'I'ING OP A PERMIT DOES NOT PRESUML <br />TO GIVE AUTHORITY TO VIOLA7'E OR CANCEL THE PROVISIONS OF ANY OTHER STATL OR LOC.V. LA1V <br />REGULATING CONSTRUCI'ION OR THE PLRFORMANCE OF CONSTAUCTION. THAT I AA4 AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORA4 TIiE 1'✓ORK FOR WHICH AYPLICATION IS MADE AND I COMPLY �VITH <br />77iE STATE CONTRACTORS LA�V 18.27 RC\V AND 29G.2001VAC. <br />Signaturc <br />,�/��?�( <br />Fcc ��� <br />dc<cpp (}Isr9;) <br />