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APPLICATION FOR ELECTRICA.L FtRMIT � <br /> ;irv oF - <br /> everett . <br /> yx n ~ 9UILDING DEPARTMENT . <br /> b7 h�>7� 259-8810 . <br /> A �7S <br /> C9 H <br /> t" �N <br /> H H 3 S I y �.��t a,.,-� -le..-� �82°� �-sg-y 3 3 I <br /> [�(4r.� �4✓ �l� <br /> K y � (Mncr ni dress ty p honc <br /> �� � S�1„� L <br /> yy~ enan[ ai ddress �ty �p �ane <br /> �i y� �A•^^� ' <br /> e ectnea ontrac[or ai ress 1 y p hone �cense a . <br /> ��g : <br /> L�� O �ontrat[ r tt o ar ropo,c sc o u� tl�ng : <br /> H <br /> zy� <br /> x ro)ecC tltlress ' 1 d �^ �y/— / <br /> �yyy � y�jJ^ Vir,,..i �aC/f /IV{— � Zvl'"�-v/ LO: / � <br /> O H <br /> O Cy fA tscnption o Work o e one: � <br /> � t� � /�D� �Pn+O — S <br /> zyv, � . <br /> y p y " <br /> Y <br /> i <br /> -- Y <br /> � R <br /> � F <br /> I '__ L <br /> ��I NOTE: WAC 296-46-740 REOUIRES THAT PLANS FOR EL[CTRICAL WORK AT E�UCATIONAL� INSTITUTIONRL OR HEALTH CARE FACILITIES F <br /> BE APPROVE� BY THE STATE OF XASIiINGTON. APPLICAI�TS WITH SUCH J085 HUST SHOW THE STATE APPROVED PLANS BEFORE A r"a <br /> CITY OF EVERETT PERMIT WILL BE ISSUED. S <br /> ' '�� NOTE: WIRINC IN NON-DWELLINGS IS REOUIRED TO �E IN METAI RACF.N'AYS. � <br /> � � � � 3 � <br /> � � �( i <br /> I HEREBY CERTIFY THAT I HAVE PEA[1 AND EXAMINED THIS P <br /> =1 ' APPLICATION AND KNOW THE SAME TO BE TRUE AND CORFECT.ALL ; <br /> � PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS NPE Of t <br /> WORK WILL BE COMPLETED WITH WHETHEfi SPECIFIED HEREIN OR ' <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE � <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY . <br /> OTHER S7ATE OR IOCAL LAW REGULAT�NG CONSTRUCTION OR THE ,f ! <br /> '�! pERFORMANCE OF CONSTRUGTION.THAT I AM AUTHORI2ED BY THE �J� : <br /> � OWNER OF THIS PtiOPERTY TO PERFORM THE WORK FOR WHICH FEE _ ' <br /> APPLICATION IS MADE AND I COAIPLY WITH THE STATE � <br /> � CONTRACTORS LAW 1827 RCW AN�296.200�'dAC. � <br /> ' �1 , 1 <br /> �� � <br /> x�_ P��l 3_��-�2- ' ' <br /> Signaturc Date <br />