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, w.,: <br /> l� <br /> �..� ,.,„.�,�, <br /> p <br /> c �, <br /> ! <br /> i <br /> � <br /> ��� <br /> ��� , <br /> ������ <br /> o�� APPLICATIUN F�R ELECTRICAL F'ERMIT <br /> � <br /> � � <br /> ��.,� I <br /> ,�,�y ;incF i <br /> ty�~jpH evere#t � <br /> a�� BUILDING DEPART6IENT , <br /> 259•8810 � <br /> �6� I <br /> _ h'e�u� n j <br /> ����rt a �2To�� l`73/-I/irta�,,;�+ fvrKclf" ���2C-i 339-��R/ � <br /> ��e� NaiT-'a�ress ty p ho e I <br /> � Q I� <br /> �l/1/l7'I /J�NriYl Ifl�� -- . <br /> �nant a ddress Z C� hO^� � <br /> i <br /> iirhu., 1=�rcT '� S�b;2/ yld:+v�" STA-��vsal �S`J-175S" � itrtyE/S/CI ; <br /> c etnca ontraceo—r�1ai adress cCT y— � non�—��cenae <br /> � .7in,"r�l�A� i �i.5 , '�, <br /> oneract r ce o Mor , ropo37 se o �l3�ng , <br /> ,r � - � <br /> /1 � �� yA <br /> ro)ect Odrets <br /> i�- - .� tin D.r � „�9 4 Gin,�, 4 if's I. <br /> i�'scr pe on o Nork o e a e: <br /> C�' <br /> � <br /> � j __ � <br /> ; �_s <br /> I ' ' ' NOTE: MAC 296-46-100 REOUIftES THAT PLANS FOR ELECTHIGL 'MORK AT E�UGSIONAL� INSTITUTIOHAL OR IIEALTH GRE FACILITIES <br /> BE APPROVEO BY THE STATE OF NASHINGTON. APPLIUNTS MITH SUCH JO85 MUST SHOX THE STATE APPNOVED PLANS BEFORE .1 <br /> CITY OF EYERETT PERMIT MIIL BE ISSUEO. <br /> w IIOTE: MIRINL IN NON-OMELLINCS IS REOUIREO TO BE IN t1ETAL MCEWAYS. /�J <br /> � � ��� � <br /> i.� <br /> I_'�' I HEREBY CERTIFY THAT I HAVE FEAD AND EXAMINED THIS <br /> APPUCATION ANO KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> PROV�SIONS OF UW;.AND OROINANCES GOVERNING THIS TYPE OF . <br /> I WORK WILL BE COMPLETED WITH WHETNER SPECIFIED HtREIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> I I � � AUTHOflITY TO VIOIATE Oq CANCEL THE PROVISIONS OF ANY <br /> � � 01HEfl STATE OR LOCAL UW REGULATING CONSTRUCTION OR iHE <br /> \ PERFORMANCE OF CONSTRUCTION.THAT 1 AM AUTHUFIZED BY TNE <br /> OWNER OF THIS PROPEHN TO PERFOHM THE WORN FOR WNICH FEE .3.5, r�(� <br /> APPIICATION IS MADE ANO I COMPLY WITH THE STATE <br /> GONTRACTORS U1W 10.27 RCW ANO 296.200 WAC. <br /> " Q�«� ,Lty �- ,� � Y <br /> Sig�(ature Uate <br /> _� _ _. _._ ___._._�� <br />