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APPLICATiuiJ FOR ELECTRICAl. FcRMIT <br /> : �� i� ���� � � <br /> anoF <br /> everett <br /> y �H BUILDING OEPARTMENT <br /> x�';f 259�8810 <br /> Df <br /> p � x <br /> q H <br /> > HN <br /> H �y <br /> � i�_,.. _ on� u i� v� �5�'S� Q�'oac+�t�xcU ,�uer�� Ll� 9!',�D/ .,ZS9� 'f_i3/ <br /> y ~ ener,/ ai adress ty ^Iip—Phana <br /> C) x O /�/� <br /> h� y H enan a� d resa Cy p hone <br /> yxx �E`� <br /> LT7 y � ET_ct,r/c ontractor ai res��d�i�s—�ity p hane cense <br /> �y N�/f <br /> H �p ontr ct r ce o ' or ropose se a u d nq <br /> 4]� O /' <br /> ) <br /> z y� �'!C�,�' /i� c't�� C'/'<'.� t' ��i'��� <br /> ro ect ress <br /> z � <br /> ��"� y /ii.i /1'Pir/ I1.00CSG .✓DD QL�2.0 � 21d/L¢� <br /> y �..� 6iscnpt on TMur o e ane: <br /> C']C7 C/� <br /> ��� <br /> HO� <br /> �� <br /> ��� NOTE: WAC 296-46-190 REOUIRES THAT PLANS FOR ELECTRICAL WORK Ai EDUGTIONAL� INSTITUTIONAL OR NEALTN CARE FACILITIES <br /> � BE APPROVED BY THE STATE OF MASHINCTON. APPLIGINTS MIiH SUCH JO85 NUSi SN011 THE STATE APPROV'_D PLANS BEFORE A <br /> CITY OF EVERETT PERM�T NILL 6E ISSUED. <br /> NOTE: WIRING IN tlON-DWELLINGS IS REOUIRED i0 �E IN CONDUIT. <br /> �_ <br /> I �� <br /> i <br /> I HEREBY CERTIFY TNAT 1 HAVE FEAO ANU EXAMINED THIS <br /> APPIICAT10N AN�KNOW THE SAME TO BE TRUE AND CORflECT.ALL <br /> � �� PROVISIONS OF LAWS AND ORDINANCES GOVERNINQ THIS TYPE OF � , <br /> WORK WILL BE COMPLETED WIfH YIHETHEFi SPECIFIE�HEREIN OR <br /> NOT. THE GRANTING OF A FERMIT DOES NOT PRESUME TO GIVE <br /> AUTHOFITY TO VIOIAtE OR CANCEL THE PROVISIONS OF ANY � � <br /> OTHER STATE OR LOCAL IAW REGUTATING CONSTRUCTION OR THE � <br /> ��� PERFORhU1NCE OF CONSTRUCTION.THAT I AM AUTHORIZE�BY THE . <br /> � OWNEP. OF THIS PROPERiY TO PERFOFM THE\YORK FOR WHICH FEE <br /> ' APPLICATION IS MA�E AND I COMPLY WITH THE STA7E <br /> I CONTRACTORS LAW 10.27 RCW AND 296.200 WAC. \ <br /> I � . <br /> � �� i <br /> � X -�;� (. . � �; <br /> ,�f. _ �-,.,-:�„ : , �� �'� �; <br /> Siqnature Date' � <br /> '� 7�a� <br />