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CITY O� EVGRETT <br />➢UILDMG I`NISION <br />3200 C[DAR STRLET <br />LVERlIT. WA 98201 <br />APPLICATION TOR ELECI'RICAL PGIL111'I' <br />dEGEGT yor„c 5 <br />Owncr t.fail Addrcss ���y <br />Tcnant Moil AdJress Cily <br />Mail AJdrets <br />/firxJ.LYJ <br />Conlract Pncc o( \5brk <br />59�B o�Rd %R,6'6'_�(/EST <br />Frojccl Addmsc <br />Dcscriplion o(\Vork to IIc Done _�c�i�..�i aEQVKE <br />Slate/Zip <br />SL�Ic/Zip <br />/��3 <br />c�iy s�i�iz�� rt,o�� <br />�-I <br />Pmpased Use o( llu.IJing <br />�� <br />259-8810 <br />Phone <br />PLonc <br />SL�tc Licensc No. <br />NOTE: \VAC 296-16•I40 �RLQUIRES 771AT PLANS FOR ELECI'It1CAL \VOR}: AT L•DUCATIONAL, INSTITUTIONAL OR <br />IiEALTFt CARG iACILITICS BE AFPRO\'ED 6Y TItG STATE OF WASHINGiON. APFLICANTS WITfI SUCH ]ODS <br />AfUST SHOW THE STA7'G APPROVED PLANS ➢EPORE CCfI' OF EVGRL•T PLRntI71V1LL DE ISSUGD. <br />NOTE: WIRING 1N NON-D\l'GLLINGS IS REQUIRED TO ➢E W RIGTALLiC RACG\4AYS (MC M1D AC, ARE CA[1LGS, <br />NOi RACE\VAYS). <br />f HERIiBY CERTIFY TFiAT 11{pVG RHAD AND EXAMINGD 7HIS APPLICATION AND KNOW THG SAME TO BE TRUL• <br />AND CORRECf. ALL PROVISIONS OP LAWS AND ORDWANCBS GOVERNING THIS T1'PE OP WORK \59I.L AG <br />COAfPLGI'LD WITIt WlitiI7iGR SPLCIFILD 13GRGIN OR NOT. THE GRANTING OF A PERt�:IT DO[5 NOT iBC:SU�f[ <br />l'O GIVG AUTHORITY TO VIOLATE OR CANCGL THG PROVISIONS aF AN7' OTHGR S7�,CI'F. OR LOCAL LnN' <br />RLGULATING CONSTRUCiION OR THB PGRFOR�fANCE OP Co�S1�RUl'7lON, TIi.\T 1.1�1 nUtHnRI719b I11' TIIE <br />O\VNGR OP THIS PROPERTY TO PERPORi.f TliE \VORK POR N71I� li n19'LIC.A'I'IOV Iti p1nDi1 :11U I CO�!i'Ll' \VITH <br />TFIG STATL CONTRACTORS LAN' 18.27 RCW AND 296.200 \i'AC. <br />Signa�uro <br />I a�S$_ro <br />��•�-rr N<e, <br />