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APPLICATION TOR CLECTRICAI,PGI2114IT <br /> crrv or•cvexsErr � <br /> HUfLDMG DIVISION <br /> 3200 CEDAR S772ELT <br /> EVEREIT,WA 98201 <br /> ?59-8870 <br /> �il/ G,,,,�:�..,,� /G��/ fl�,.,l,w ��N ic�✓ ry�a � ,�,sF-,��i <br /> Owoer �tail Address City S1atd2ip F'hone <br /> Teoant . . . hlail Address City SutdZip � Phooe <br /> fC �- �- <br /> Elatrial Contnctor Mail Addmsa Cily SlaldZip Phone State License No. <br /> Contncl Price of\Vork7 Proposal Uu of Iiuilding -- <br /> ��j(r�nn J <br /> Pro�ect Address <br /> Description of\Vork lo Be Done: 2 4✓ix Q �[�/M O, /,�Zl(.��"N%(:.2�r �t/,A,.P �'/Ipy,�--� f- <br /> 1c-�•-�,.�n,,, � r <br /> � i , i � <br /> NOTE:R'AC 296-4Gd40�REQUIRES THAT PLANS FOR ELECTRICAL WORK AT EDUCATIONAL,INSTTTUTIONAL OR <br /> HEALTy CARH FACILRIES D'e APPROVED BY T79E STATG OF WASHINGTON. APPLICANTS WITf9 SUCH IOBS <br /> MUST SHOW THL STA7'8 MPROVED PLpNS BGFORE CI'I'Y OP EVLRET PGRMIT WILL 6E ISSUED. <br /> NOTE:WIRING IN NON-DWELLINGS IS REQUIRLD TO Bfi IN METALLIC RACGWAYS(MC AND AC, ARE CAllLES, <br /> NOT RACGWAYS). <br /> I HEfiEDY CERTIPY THAT I NAVE RGAD AND EXAMINED TI{IS APpLICATiON AYD KNOW THG SMfE TO HE TRUG <br /> AND CORAECT. ALL PROVISIONS OF LAWS AND ORDWANCHS GOVERNING THIS TYPE OF WORK N7LL BG <br /> COAfPLGTED WiTy WF�)F:THER SPECIFI[D FiLW:IN OR NOT. THH GRANTING OF A PERMIT DOES NOT PRESU�iL' <br /> TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHGR STATE OR LOCAL LAW <br /> REGULATING CONSTRUCf10N OR TIfE PERFOfN1ANCE OF CONSTRUCTION. TNAT I AM AUTHORIZ[D BY THE <br /> ON'NER OP THIS PROPERTY TO PERFORM THE WORK FOR W111CIi APPLICATTONI IS MADE AND 1 COMPLY WITH <br /> TIaE STATB COh1RACTORS LAW 18.27 RCW AND 296.200 WAC. <br /> X ���vL'�:"I / <br /> / "���i�M�- �/7' �} �i� — <br /> Fee <br /> tiignature Date <br /> d«.rr��sroa� <br />