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--�... <br /> ---- ----- ...._... , _._.._ _« <br /> APPLICATION FOR ELECTRICAL PERMIT � <br /> CITV OF ... � <br /> everett . <br /> BUILDING DEPARTMENT � <br /> 259-8810 <br /> « a dAress , ty p hone <br /> ►^l1�coU��=y c�";,-w�cz,orl ,, P>�x 5 � �r� 355-Zo79 <br /> ,��a�� P R 7 ►-� ��� s <br /> a� d ress �it��p hone <br /> ectr�ca ontractor ai ress t <br /> Y �p hone �Cense <br /> 1Z�5s h-�r+J ����-c-��� c., ,�� c... �c�x �0�{1 ,����'�sJl�. 1d�5-s4?3 �t 3 <br /> lontrac[ Ynte oF Xork roposed se o uilaing <br /> ro�ett ddress — <br /> ZZ.1 q 1��Ce-�t <br /> iscription o Mork o e one: <br /> — W IK�= N� IO U�\� P+f'S. '�„�c, <br /> NOTE: KAC 296-46-140 REOUIRES (HAT PLANS FOR ELECTRICAL WORK AT EDUCATIONAL� INSTITUTIONAL OR HEALTN CARE FACILITIES <br /> BE APPROVED BY THE STATE OF MASHINGTON. APPIICANTS XITH SUCIi JOBS MUST SHOW TFIE STAIE APPROVED PLANS BE�ORE A <br /> CITY OF EVENETT PERNIT MIIL 9E ISSUEO. <br /> NOTE: MIRING IN NON-DMELLINGS IS REpUIRED TO Bf IN M[TAl RACEXAYS. <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMIN[D TI{IS <br /> APPLICATION ANO KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> PROVISIONS OF IAWS AND ORDINANCES GOVERNING THIS NPE OF <br /> WORK WILL BE COMP�ETED WITH WHETHER SPECIFIED HEREIN OR <br /> NOT THE GRANTING OF A PERMIT DOES NOT PfiESUME TO GIVE <br /> AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF ANV <br /> OTHER STR7 OR IOCAL lAW REGULATING CONSiRUCTION OR THE <br /> PCRFOR OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER IS PROPERTY TO PERFORM THE WORK FOR WHICH FEE � <br /> APPLICA IS MADE nND I COMPLY WITH THE STATE —• <br /> CONTRA T S LAW 1827 RCW AND 296200 WAC. <br /> X r_. I _CI 3 <br /> o `1 <br /> Signa[ure Oat:e � <br /> �/s�� <br />