Laserfiche WebLink
ELE�RICAL PERMIT A"PLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 <br />����' S y�-�, �a�e <br />PROJECT ADDRESS , <br />G�vner <br />Tenant <br />Electrical Contrar.tor <br />h1ail Addres, <br />Mail Address <br />�• �,C, /0.�( <br />Mail Adtlress <br />�,Q _n d) E(� l ( vY � <br />Slate License Number <br />� �� <br />Proposed Use of Building <br />Description of Work to Be Done: <br />„ U � <br />Cs <br />City <br />City <br />State/Zip <br />State2ip <br />Slate2ip <br />Contracl Price of Work <br />Contact Person (Plan Review) <br />iCJ <br />Phone <br />Phone <br />_l ��� <br />Phone <br />NOTE: PLANS FOR ELECTRICAL WORK AT EDUCATIONAL, FACILITIES UTILIZING STATE FUNDS MUST BE <br />APPRCVED BY THE STATE OF WASHINGTON. AF'PLICANTS WITH SUCH JOBS MUST SHOW THE STATE <br />EDUCAT ONAL FACIUTIE�S AND ALL �HEALTH CARE FACILIITI SI PLANS WSLLE E REV EW ED BY THIS OFFI OTHER <br />I�OTE: WIRING IN NON-DWGLLINGS IS REOUIRED TO BE IN RACEWAYS, MC OR AC CABLE. <br />HANDICAPPED ACCESSIBILITY: ELECTRICAL AND COMtv1UNICATIONS SYSTEM RECEPTACLES ON NALLS <br />W ITHIN ACC_SSIBLE SPACES OR ALONG ACCESSIBLE ROUTES OF TFAVEL SHALL BE MOUNTED A MINIMUM <br />OF 15 INCHES ABOVE THE FLOOR. WAC 51-20 SEC. 3106(c)�. <br />ENVIRONMENTAL AND OTHER CONTROL RECcPTACLES AND OTHER C;?ERABLE EQUIPMENT WITHIN <br />RANGES O,� WAC SE 20 SEC.�N 6(b)4CE & FIP NDR OT�LESS THAN 36LINCHES PBO � THE D OOR.IN THE FEACH <br />I HEFEBY CE9TIFY THAT I HAVE READ AND EXAMINEO THIS APPLICATION AN� KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PFOVISIONS �F LA WS AND ORDINANCES GOVERNING THIS TYPE OF WOFK WILL BE COMPLETED WHE7HEF SPEClFIED HEREIN OR <br />'JOi, 7HE GF-�NTING OF A PERMI7 DOES NOT PRESUME TO GIVE AUTHORI r/' TO VIOLA7E OR CANCEL THE PFOVISIONS OF ANY OTHER <br />STATE OR L�-CAL LA W FEGULATINu' CONSTFUCTIGN OR THE PEFiFOFMAlvCE OF CONSTRUCTION. THAT 1 AM AUTHORIZED BY THE <br />C�ONTRAC�TC7S/LAWF827RCWA�N�2 6200LNAC.E WOAK FOR WHICH APPL!CATION IS MADE AND 1 COMPLY WITH THE STATE <br />�.? <br />. O.( <br />U Signawre G� Da1e <br />DEBIT & CREDIT CARDS APE NOT ACCEPTED <br />FEE <br />��3�% ���c� <br />