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APPLICAT,!�N FOR ELECTRICAL °ERMIT <br /> cm oF <br /> everett <br /> BUILDING DEPARTMENT <br /> 259•8810 � <br /> CU / <br /> / �2 /(i C. — 11c�Q t? r S l=�ll _ <br /> ne�— Ma Address ity ip hane <br /> �/ � <br /> (��I�1,� lr P �-�[�, ��P_/�'_ , ��L9/ _ , <br /> enant � a dOress ity p hone <br /> �it.AiLYJ <br /> ectr ca cntractor M��� dEress ity ip hone License � <br /> �,^2 Uc� ��c j��N� �__ <br /> ontraet n ce o ork r poseE se of�i Eing <br /> 3//J�/�� //�> � . <br /> ro�eet AdEress / <br /> iscription of Work o e one: <br /> l.J��e� i�> x z �:. �J�1��, �,��c/ <br /> NOTE: NAC 296-46-140 REOUIRES THAT PUNS FOR ELECTRICAL WORK AT EDUCATIONAL INSTITUTIONAL OR HEALTH CARE FACILITIE� <br /> BE APPROYED BY THE STATE OF MASHINCTON. APPLICANTS MITH SUCH JOBS MUST SHOW THE STATE APPROVED PLANS BEFORE A � <br /> CITY OF EVERETT PERMIT MILL 8E ISSUED. <br /> NOTE: WIRING IN NON-DWELLINGS IS REOUIRED TO BE IN CONDUIT. <br /> I HEREBY CERTIFY THAT I HAVE READ AND E%AMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> PflOVI510NS OF UJJS AND ORDINANCES GOVERNING THIS TVPE OF � <br /> WORK WILL dE COMPLETED WITH WHE7HER SPECIFIED HEREIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GWE <br /> 1UTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHEF STATE OR LOCAL LAW REGUUTING CONSTRUCTION OR THE <br /> PEfiFOFMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWPIEF OF THIS PROPERTY TO PERFOfiM THE WORK FOR WHICH FEE o��� <br /> APPLICATION IS MAUE AND I COMPLY WITH THE STATE <br /> CCNTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br /> X L� -.+( ! j_,p C�1 � i�.. :_i� <br /> Signature � Date <br /> �����j1 <br />