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APPLICATION FOR E��ECTRICAL PERMIT <br /> H3yl � <br /> CITY OF EVERHTT <br /> BUII.DING DMSION <br /> 3200 CEVAR STREHf <br /> EVERET'T,WA 98201 259-8810 <br /> � <br /> ��f�'� o F{. , 1V'1 i r 1 n� i ��Y�'1G �.cSL���� ?LL�P�\�fL,� U.L)�1:-�{� �;,. ���C� <br /> Ownet ail AddrEss G�y 5tatelZip\�T� -�Y�c� Phone <br /> 1 <br /> Tw�nt . Mail Address City SmtelZip Phone <br /> �( \ � i I � i .,y. ')c-���c. <br /> 11_ � ' , : I,.�R' "x ,l --. ,> >��/ <br /> ��r t-� �' i� L�„} �u l 1 �-I I � � �-1-C�� l�L E i�c.,l"1 � <br /> Elxtrical Contractor Mail Address City �State/Zip Phone StateL�cen No. <br /> ` � �� ��. �� <br /> �,�� h _- <br /> ConUact Price of Work Propased Use of Building <br /> `1"C� ��j 1.�P � �l �„li2 —�1� Y:T� <br /> Project Address . <br /> � <br /> DeacripUoa of Work W Be Done: ��]�'�!��� �;��i�� 11 ���� � " �r 1,- n� <br /> n <br /> �i ,—�r �� 1 � .�1�� �-kr�,�,�, .� � I <br /> •1 " <br /> NOTE:WAC 296�6-140 REQUIRES T'fi/�T PLANS FOR fiLECTRICAL WORK AT EDUGATIONAL, INSTITUTIONAL OR <br /> HEAL.TH CARE FACILITIES BE APPROVED BY THE STATE OF WASHINGTON. APPLICANTS WITH SUCIi JOBS <br /> MUST SAOW TI�STATE APPROVED PI.ANS BEFORE CITY bF EVERET PERMIT WILL BE ISSUED. <br /> NOTE:WIRING IN NON-DWELLINGS IS REQUIRED TO BE IN MET�LLIC RACEWAYS (MC AND AC, ARE CABLES, <br /> NOT RACEWAYS). <br /> I HEREBY CER'I'IFY THAT I HAVE READ AND EXAMINED'fHIS APPLICATION AND ICNOW TAE SAME TO BE TRUE <br /> AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVEIWING THIS 7'YPE OF WORK WILL BE <br /> COMPLETED WITH WI3ETHER SPECIFIED HEREIN OR NO'C. THE GRANCITIG OF A PERMIT DOES NOT PRESUME <br /> 'f0 GNE AUTHORITY TO VIOLA7'E OR CANCEL THE PZOVISIONS OF ANY O'CHER STATE OR LOCAL LAW <br /> REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. ;HAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH <br /> THE STATE CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br /> i ; <br /> � . <br /> Xjl/ ,,F`%� p � �S� /`,> f/�/��/" F� � �� <br /> l <br /> " � � -" Signature / Dale <br /> daepp(lI5197) <br />