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�� <br />� <br />crrY or Evcx�-r <br />UUILDING DIV190N <br />3200 CGDAR STRLGT <br />EVERE7'T, WA 98201 <br />APPLICATION TOR CL�CTRICAL PGRA411' <br />�Iv`I 3�`1 <br />� <br />259•8810 <br />a£r�£c.T No�s Zsj Eu«� F✓E,cErs- Wa. zs8-rsa;_ <br />Owner Mail Address City Stete/Zip Phone <br />7enan1 <br />Afail <br />Ci�y S�atdZip Phaoe <br />,_:a1 3 <br />G��. C-r.E�nic �uc. �a K� 342�G /i%e,e�m�e .GJrF. jfk83 6b9-9zw Lw.Er.EZXIa,r3 <br />Glatrical ConMcbr Mail AJdress Cily S�Ic/Zip Phane S�ite Licenu No. <br />Contacl Price o( Work Proposed Uu of Uuildirg <br />59ra 3RD AW✓E Wfsr <br />r�o�«� naa� <br />Uescription o( Work to De Done: bo �.����n S£e✓iU,= <br />NO7'E: WAC �.vo-06d40 REQUIRES 7'H9T PI.ANS FOR ELE•CTRICAI. \VORK AT EDUCATIONAL, INSTPI'UTIONAL OR <br />HEALTII CARL PACILITIL•S 3L• APFROVGD BY THE SfATE OF WASIiINGTON. MPLICM'TS WITIi SUCH SODS <br />MUST SHOW THE STATG AS'PROVED PLANS UEFORE CITl' O� EVF.R�T PERAi1T WILL UE ISSUED. <br />NOTG N7RING iN NON•DWGLUNGS IS REQUfRGD TO 6[ IN MGT.4LLIC RACGWAYS (\fC AND AC, ARE CAALES, <br />NOT RACGWAYS). <br />1 HERE➢Y CERTIFI' THAT 1 HAVE READ AND EXAAI�NED TFi15 APPUCATION AND KNOW TI1E SAh1G TO DE TRUG <br />AND CORRL•CC. ALL PROVISIONS O� LAWS AND ORDINF��CES GOVERNING THIS TYPE UF WORR NRLL DE <br />CO�fPLEfHD WfCH \VF3E7'HCR SPECIFIED HERGIN OR NOT. THE GRANTING OF A PERAIIT DOES NOT PRLSUMG <br />TO GNE AUTHORITY TO VIOLATE OR CANCGL THE Pf.OVISIONS OF ANY OTHER ST.\TE OR LOCAL LAW <br />REGULATING CONSTRUCI'fON OR THE P[RFORI.SANCE Oi CON51'RUCfION. THAT 1 AM AUT130RIZ[D BY THG <br />O\VNLR OF THIS PROPERTI' TO PERFORTf THE N'ORK P'OR �193ICIi APPLIC!'IJN IS �fAUG AND I COMPLY WITH <br />THG STATE CONTRAC'.�ORS LAW 18.27 RC\V AND 296.'00 N:^ C. <br />SignaNre <br />Date <br />,`J0� <br />_ 1� <br />r•u <br />a.�.vr �rsro» <br />