Laserfiche WebLink
APPLICATION FOR �L�CTRICAL P�RIVIIT <br /> ,��1-�- { <br /> CITY OF EVERLTT <br /> IIUIL.DING DIVI�ION <br /> 3200 CEDAR STREET <br /> L•VERETT, WA 98201 <br /> 259-8810 <br /> n�fyC��n ���YtST�f�L�� v� ��� L7!'�X i� �� � �Vt°{'L�-�' �r�a�J <br /> Ownet � Ma�1 Address � .'� ^� <br /> City Seate/Zip Phone <br /> Teoent Mail Address <br /> CitY Stale/Zip Phone <br /> �m O KPy � T1- �_/.�� �D �/�,C �/s/ A �I r7`__ f <br /> Electncal Contraodor Mail Address C�ty Slale/Z�P Phoue���'— �� <br /> Stale License No. <br /> Conlract Price of Work � <br /> `7 Proposed e of Building <br /> �'S� � (� � 7 L�!>!J ��,r—�—LZ <br /> Pro�ect Address <br /> Description of Work to De Done: W\�� — <br /> — IC'UO /�- w� ervice5 <br /> NOTE:WAC 296-46-140 RLQUIRES THAT PLANS FOR ELECTRICAL WORK AT EDUCATIONAL, iNSTITUTIONAL OR <br /> HEALTH CpRE pACILITIES gE pppROVED BY THE STATE OF WASHINGTON. APPLICANTS WITH SUCH JOBS <br /> MUST SHOW THE STATE APPROVED PLANS BEFORS CPPY OF EVERET PERMIT WILL BL ISSUED. <br /> NOTE:WIRING IN NON-DWELLINGS IS RLQUIRED TO HE IN METALLIC RACEWAYS (MC AND AC, ARE CABLES, <br /> NOT RACEWAYS). <br /> I HEREBY CERTIFY THAT I:iAVE RGAD AND EXAMINLD THIS APPLICATION AND KNOW THE SAME TO BE TRUE <br /> AND CORRHC'/', qLL PROVISIONS OF LAWS AND ORDINANCES GOVEItNING THIS TYPE OF \:'ORK WILL BE <br /> COMPLETED WITH WAETHER SPECIFIL•D HLe2EIN OR NOT. THE GRANTING OF A PERMIT DOLS NOT PRPSUME <br /> TO GIVE AUTHORITY TO VIOLATL- OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW <br /> REGULATING CONSTKUCl'ION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZGD BY THE <br /> OWNER OF TH1S PROPERTY TO PERFORM THL WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH <br /> THE STATE CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br /> X <br /> _ -� �'' — $�oo <br /> Signa W re Pee <br /> Date <br /> ck�srr P�5�93� <br />