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APPLICA�-�N FOR ELECTRICAL�ERMIT <br />l:iVUF <br />�verett <br />BUILDING DEPAFTMENT <br />259-8810 <br />DAvio Y�t•PqR�uv SS�o�-5.�..d Cvcarlt 9,P�o8 as'8-�s�oy o,e ��f�-r�o� <br />ner Mail Atltlrcss ity iip hone <br />�/� <br />enant Mai tleress i[y �p hone <br />OW �Grn <br />ecV ca ontractor� ai ddrcss ty ip hone icense # <br />lzesroe.tcc= <br />ontract�Frice o Wor ropose se o ui C ng <br />S8o8 S anc: rf✓ra�� ul/� `%�)-o � <br />r�ect ddress <br />iscriptian a Work o e ane: <br />��s'�Al� f("l�Qm SySiEN7 <br />NOTE: WAC 296-46-140 REOUIRES THAT PLA'JS FOR ELECTRICAL A'ORK AT E�UCATIONAL� INSTITUTIONAL OR HEALTH CARE Fdd U TIES <br />BE APPROVED BY THE STATE OF WASHINGTON. FPPLICANTS WITH SUCH JOBS MUST SHOW THE STATE APPROVED PLAt15 OEFORE A <br />CITY OF EVERETT PERMIT WILL BE I:iSUED. <br />NOTE: WIRING IN NON-DWELLINGS IS REOIiIRE� TO BE IN CO`IOUIT. <br />I HEREBY CEfiTIFY THAT I HAVE READ ANO EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORflECT. ALL <br />PflOVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLETED WITH WHETHEfl SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PEFMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANV <br />OTHER STATE OR LOCAL LAW REGUTATING CONSTRUGTION OF THE <br />PEFFORMANCE OF CONSTRUCTION. THAT I AM Al1THORIZED BY TF7E <br />OWNEfl OF THIS PROPERN TO PERFORM THE WORK FOfi WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAN! 18.27 RCW AND 296200 WAC. <br />X ��l� t �� _ /.�-//f / <br />Signature Uate <br />��� <br />FEE <br />4Y�SK� <br />