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APPLICHi ION FOR ELECTRICti� PERMIT <br /> cm oF <br /> xr� <br /> everett <br /> �a y BUILDING DEPARTMENT <br /> A x7 x 259-8810 <br /> � H <br /> ��N <br /> ,� <br /> K �z .�lor, .; /✓ l� L �,.1/J� i�/ � 1 /�� G���� 7�; ��� ����� • i 3- 5 � - �/j � �� <br /> � H,.O� �e� Hai ddress Cy ip honr <br /> WH <br /> .,.. ¢ <br /> � none <br /> � 0�` enan[ Mai d ress �ty �p <br /> �� <br /> OH <br /> H �g ectn ca ontractor ai eress ty p hone tcense x <br /> • <br /> L). ('] �" i✓� �� r <br /> H ro ose st c ui tl ng <br /> Ay ontract r ce o Wor 7 <br /> r z <br /> r-i y <br /> �y y ro�ect EOress <br /> O 1-� <br /> oCt7�n 17 / U l/� c ,ru � ,/ L. l-�. G� ,� <br /> y+ �r+ iscnpNon o Work o onc: <br /> �Z� �-3`r�n I � 57/� l � �� r^ �� lr 'I /5oK �ih 5 ; �la � DHo oyl ) : c�°� /�cX <br /> H O[n <br /> � DLtD /7 i Yilo C v rch f��- /) ar����� ��F�/`1 �f�, J /3 oK ��'� <br /> TI�N J L ' ��+ � <br /> � � . <br /> "'^ ! NOTE: WAC 296-46-740 REpUIRES THAT PUNS fOR ELECTRICAL MORK AT EDUCATIONAL� INSTITUTIONAL OR HEALTH CARE FACII_ITIES <br /> BE APPROVED BY THE STRTE OF MASHINGTON. APPLICANTS MITH SUCH JOBS MUST SHOM THE STATE APPROVED PLANS OEfORE A <br /> CITY OF EVERETT PERMIT MILL BE ISSUED. <br /> (M �� NOTE: MIRING IN NON-DWELLINGS IS REOUIREO TO 9E IN METAL RACEMAYS. <br /> � -+ I HEREBY CERTIFY THAT I HAVE FiEAD AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF _ <br /> 9� � WORK WILL BE COMPLEfED WI"�'H WHETHER SPECIFIED HEREIN OR <br /> `� NOT.TNE GRANTING OF A PERMIT OOES NOT PRESUME TO GIVE <br /> AUTHCRITY TO VIOLATE OR CANCEL THE PFiOVISIONS OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTICN OR THE <br /> PERFORIAANCE OF CONSTRUCTION.THAT I AM AUTHORIZI:D BY THE <br /> OWNER OF THIS PROPERTY i0 PERFORM THE WORK FJR WHICH FEE G�" <br /> " APPLICATION IS MADE .1ND I COMPLY WITH TIiE STATE <br /> CONTRACTORS LAW 7827 RCW AND 296200 WAC. <br /> � � ��'� � -���.7��! <br /> — X i l.tn�n-�/ l�/ ��.ti.,..�G�-4 /v�5�y s_ <br /> Signature Date <br />