Laserfiche WebLink
APPLICATfVN FOR EL�CTRICAL FcRMlT <br /> j , .. <br /> � � , � <br /> cirv oF <br /> everett <br /> BUILOING DEPARTti�GNT , <br /> 259-8010 <br /> � � � <br /> G �y <br /> H � m o•� �«C io� �'S�'S� �rnnt�tvn r/ .�dric t� LG,�i 9.V,Z0� :�759- �fj3/ <br /> —r� n a <br /> -�i y y �ner a Addresa �Y P <br /> K �� �� a d resa ty p one <br /> enan <br /> �H� � hane cense <br /> U1 H ectr c ontractor �a resa �Y P <br /> � Qy� an[���r ce a Nor fopose se a u d ng � <br /> O H � � /� <br /> � " g ��.�,; �, - <br /> �� pC ro ecc aress � <br /> � �„� Y / . u �'/'d/G o� <br /> y z� script on o Wor o e one: <br /> HH <br /> g �' <br /> H <br /> n C f/� <br /> � �� <br /> HOCNi, <br /> i � NOTE: WAC 296-46-140 FEOUIPES THAT PLANS FOR ELECTRICAL WORK AT E�UCATIONAL� INSTITUTIONRI OR HEAIiH CARE FACILITIES <br /> i BE APPROVED BY THE STATE OF XASHINGTON. ApPLICANTS MIiH SUCH J095 MUST SHON THE SiATE APPRO'!ED PLANS BEFORE 11 <br /> ,_�' CITY OF EYERETT PERNIi NILL BE ISSUED. <br /> �� t70TE: WIRINC IN 170N-�WELLINGS IS REOUIRED TO �E IN CONOUIT. <br /> � _ <br /> I ��' I HEf1EBY CERTIFY THAT 1 HAVE READ AND E%AMINED THIS <br /> APPIICATION AND KNOW THE SAME TO DE TFUE AND CORRECL ALL <br /> PROVISIONS OF LAWS AND OR�INANCES GOVERNING THIS 7YPE OF , <br /> �� WOFK WILL BE COMPLETED WITH K'NETHER SPECIFIED HEREIN OR <br /> I 1' NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO G�VE <br /> AUTHORITY TO VIOLATE OH CANCEL THE PROVISIONS OF ANY <br /> � OTHER STATE OR LOCAL LAW REGUTATING CONSTFUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE . <br /> APPLICATFONISISRMADE ANDPI COMPLY WITOHKT ER STATE FEE <br /> . �'� CONiRACTOF5U1W1B.27FCWAN�:96.�00WAC. <br /> �.o X_'f �/� � . �� . ,�,! � <br /> � f(l <br /> Signature Date <br /> 3��� � <br /> - — -- --- <br /> s <br />