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�.i'Gi ` <br /> i �:� <br /> � A <br /> � <br /> F_�, <br /> ♦W Ia'a I <br /> APPLICATION FOR ELECTRICAL PERMIT <br /> cin oF �err <br /> k1UILDINC DIVISION � <br /> � M 3200 CmM STREET <br /> �� EYERETT� YA 98201 <br /> A�H 25^9-88f0 <br /> r �� � ��I \I ^ � �1�1 �' (Y' � II C � / ) � ��pe'l �5_S��-.2�� { '. <br /> H 3 t�-> I�cKC.Y, J'` 'C�I Ol��. i� ciV� L S(� (�--✓° � . <br /> Kn ner —Fai Address '�ity tate �p hone <br /> H xl <br /> �°a H� — SA,��' ,d� cc•�n£� -- <br /> N~ ai ddross ity tate ip hone <br /> H � <br /> enant <br /> � ''�' d C� 1J C�� <br /> O H �� tate i hone tatc icens�o. <br /> � �C ectn ca ontractor ai ddress Y P <br /> O ,cxl <br /> c�-�1" " � ��G� �''SiC�F/'�C'� — S � 1�{ <br /> T+ H roposed se o ui ding <br /> 9 H ontract r ce o or , <br /> Y <br /> r ~y � '� �l�F . �G/ <br /> g � �/rl� �c���� ,�z c��t� <br /> M <br /> O C7N ro�ect ddress <br /> � C� <br /> �T=��-�-� 9� ��,e�� �x�sJ,�� ,;���r <br /> y yO y Discription of Work To Be �one: fV� <br /> ��- �-,,,C' r a� �Y�,�i�� � ,1G =CY� �d���i�' •— �I�C� �'�,�� s <br /> /y�f�t� /X�X /d r�i�'� �.�c'(' �04 6�S� <br /> �—� <br /> _� <br /> .� �, NOTE: WAC 296-46-740 REOUIRES THAT PLANS FOR ELECTRICFL WORK AT E�UCATIONAL, INSTITUTIONAL OR HEALTH CARE FACILITIES <br /> � `� BE FPPROVED BY THE STATE OF WASHINGTON. APPLICANTS WITH SULH JOBS MUST SHOW THE STATE APPROVED PLANS BEFORE A <br /> CITY OF EVERETT PERMIT WILL BE ISSUED. <br /> NOTE: WIRING IN NON-DWELLINCS IS REpUIRED TO 8c IN CONDUIT. <br /> '�� <br /> �y� <br /> 1 HEREBY CERTIFY THAT I HAVE PEAD AND' E%AMINEO THIS <br /> ''.�' APPLJCATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> PROVISIONS OF UWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> WORK WILL BE COMPIEfED WITH WHE7HEfl SPECIFIED HEREIN OR <br /> NOT.THE GFANTING OF A PERMIT OOES NOT PRESUM1IE TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> ' I i OTHER STATE OR LOCAL LAW FiEGUTATING CONSTRUCTION OR THE ` <br /> PEFFORMANCE OF CONSTAUCTION.THAT I AM AUTHORIZED BY THE . _ <br /> OWNEF OF THIS PP.OPERTY TO PERFORM THE WORK FOR WHICH FEE ��� <br /> qp�+��� IS MADE COMPLY WITH THE S7ATE � <br /> '' ' //CONTRACTORS 18.2T GW AND 200 WAC• <br /> l /�/�(� ___� ._ , <br /> �\ X � . { �+�OV _ '—_•-- �/��''� �J ,1�. , �Jl� <br /> � ' -' \�/i' / <br /> ' �� ��$ignature �� Oate � � �` <br />