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ELEC'� r�ICAL PEF�MI'T AF�LICA`�ION <br /> CITY OF EVERETT PERfVIIT SERVICES <br /> 3200 CEDPR STREET, EVERETT, b'iA 98201 '�j —a '�O 3 <br /> 425-257-A810 - FAX 425-257-Sd57 I-� l/,';C_�'.' -;;.' ? .� <br /> -;��'�. T I ._I I�.;� � �-f� t,� ��, l`� �=-� / <br /> PROJECT ADDRESS � V � <br /> i <br /> -- i�.- r; � .. ,� ( _�r� ✓��� � uZ�;19 - zSRJ <br /> Owner Mail Atldress City State2ip Phone <br /> Tenant Mail Address City State2ip Phone <br /> '_�- a •C � i � c j� <br /> Eleclrical Contraclor ' Idail Address Ciry State2ip Phune <br /> Stale Lir,ense Num6er Coniract Price of Work <br /> ��,. �.' ._�„i ,"" - <br /> Proposed Use ol Buildiny Contact Person (Plan Review) <br /> ) <br /> Descrip�ion ol Work to Be Donc: �L�: ,�- � �- �� � �� � � s�� 2 c-• / C iJ � <br /> � � <br /> NOTE: PLANS FOR [L[CTHICAL WORK AT EDUCATIONAL. FACILITIES UTILIZING STATE FUNDS Iu1UST 8E <br /> APPROVED BY THE STATE OF WASHINGTON. APPLI�ANTS WITH SUCH JOBS MUST SHOW THE STATE <br /> APPROVED PLANS BEF�RE CITY C� EVERETT PERMIf WILL �E ISSUED. WAC 296-46-140. ALL OTHER <br /> EDUCATIONAL FACILITIES AND ALL HEALI H CARE FACILITIFS PLANS W ILL BE REVIEW ED BY THIS OFFICE. <br /> NOT[: WIRING IN NON•DWELLINGS IS RE(]UIRED TO E!E IN RACEWAYS, MC OR AC CABLE. <br /> HANDICAPPED ACCESSIBILITY: ELECTRICAL AND COMMUNICATIONS SYSTEM RECEPTACLES GN WALLS <br /> WITHIN ACCESSIBLE SPACES OR A�ONG ACCESSIBLE ROUTES OF TRAVEL SHALL BE MOUNTED f� MINIMUM <br /> OF 15 INCHES ABOVE THE FLOOR. WAC 51-20 SEC. 3106(c)2. <br /> ENVIRONMENTAL AND OTHER CONTROL RECEPTACLES AND OTHER OPERABL� EGU�P�"cNT WITHIN <br /> ACCESSIBLE SPACES OR ALONG ACCESSIBLE ROUTES OF TRAVEL SHALL BE MOUNTED WITHIN THE REACH <br /> RANGES OF WAC 51-20 SEC. 3106(b�4 E & F AND NOT LESS THAN 36 INCHES ABUVE THE FLOOR. <br /> 1 HtFEB}' CERTIFI' TNA7"1 HAVE READ ANO EXAM1IINED 7HIS APPLICATfON AND KNObV THE SAh9E TO BE TRUE AND COFFECL ALL <br /> PROVICIONS OF Lr7W5 AND OFDINANCES GOVERNING THIS TYPE OF INJRK WILL BE COfAPLETED WHE�fHEP SPEGFIEG HEFEIN OR <br /> �VOT, THE GRANTING CF A PEFMIT DOES NOT PFESUh1E i O GI VE AUTHOFITY TO VlQL77E OR CANCEL THE PROVIS10N5 CF ANY OTHER <br /> SL4TE OR LOCAL LAL'✓ FEGUL4TING CONSTFUCTION OR 7HE PERFOFh1ANCE OF CONSTFUCTION. THAT 1 Ald AVTHOFIZED EY THE <br /> Cll'fJER Cl= 7�ilS PFCFEFTI� 70 PEFFOFRI THE WCFK FOF IVHICH APPLICATION IS hfADE ANO 1 COMPLY 11'I7H THC- 6%A7E <br /> CCNTF4CTORS'1_A lV :8 C:FG l i�AND 2P6100 IYAC. <br /> �>> <br /> ��— �_ � � _� FEE <br /> Signaturc Dale <br /> DEBIT & CREDIT CARDS ARE NOT ACCEPTED �-�'��'� "�'` ' � <br />