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APPLICATION TOR �L�CTRICAL P�RMIT '-�[%�3F=cl <br /> CITY OF L•VERETT <br /> DUII.DING DIVISiON <br /> ��H 3200 CEDAR STREET <br /> ';� EVERETT,WA 98201 <br /> i,q 259-8810 <br /> p�x <br /> �y�' C�,�G �G����� �Cyc � �` <br /> � r ' �20 W9"�PRL �1/G F f',E' �Z� o�sii <br /> K�n O�wcr A1ail Address Cicy State/Zip Phone <br /> H ?7 <br /> �y� ��� <br /> �j�� Teoanl - Mail Address Ciry Statc/Zip Phone <br /> � � .��> oox ���i� �B�-z�s72 <br /> tn+�.v�s G-• �.�.�.v,�v�L�c�r.c <br /> �� g 5�'•4rf`-�o G� ���� �r�a�zar,r-i��r�, <br /> G]Y (] <br /> s y� Electrical Contractor Mail Address City Stale/Zip Phooe SL�Ie License No. <br /> t•� 6� �i �.V�L'��D /'� <br /> t�i�y <br /> g H Conlacl Price of Work Proposed Use of Building <br /> ��r �ZU ��✓'fyfi�C%s�f/ Ff'! ^ �-'dQ�' �� .. <br /> ��'� Prol�t Address �— ' <br /> y <br /> y �n <br /> Descriplion of Work to Be Done: ��� �� 50–v///« G r��lir� � ���� ��� <br /> � /�J��y.�— �r�.PZP.e e.��W-�r� CoZ'��vs' <br /> s�� —�' v <br /> 1 C� <br /> - NOTE:WAC 296-46-)40 REQUIRES THAT PLANS FOR LLL-CTRICAL WOI'iK,CC EDUCATIONAL, 1NSTITUI'IONAL OR <br /> � HEALTT� CARE FACR�iTIES BE APPROVED DY THE STATL OF WASHINGTON. APPLiCANTS W1TH SUCH JOBS <br /> I �� MUST SHOW THE STA7'G APPROVED PLANS BEFORE CITY OF EVERET PLR.bfIT W[LL BE ISSUED. <br /> NOTL:WIRING IN NON-DWGLLINGS iS REQUIRL•D TO 9B IN MB'PALLiC RACEWAYS (MC AND AC, ARE CAIILES, <br /> �1_ NOT RACEWAYS). <br /> '� I HEREBY CERTIFY THAT I HAVE READ AND EXATi1NHD THIS APPLICA'IION AND KNOW TI{E SAA1E TO I3E TRUE <br /> AND CORREC'f. ALL PROVISIONS OF LAWS AND ORDINANCGS GOVERNING THIS 7'YPE OP WORK WILL BL• <br /> �� COMPLETED WITH WHLTHER SPECIPIED IiHREIN OR NOT. THE GRANi'ING OF A PERAIIT DOES NO:PRESUME <br /> �' � TO GIVL AUTHORITY TO VIOLATE OR CANCGI. THG PROVISIONS OF ANY OTHER STA7'E OR LOCAL LAW <br /> RLGULATING CONSTRUCTION OR TI�E PERFOR;�tANCE OP CONS'PRUCTION. THAT I AM AUTIiORIZED BY TIiE <br /> OWNLR OF TI{IS PROPERTY TO PERFORM TYE\VORK POR WHICH APPLICATION IS DQADE AND I COMPLY WITH <br /> —1�' 'fHE STATE CON'I'ILAC'I'ORS LAW 18.27 RCW AND 296.200 WAC. <br /> ` <br /> X ���,. /,� �_, QO <br /> � i`Lp��� ��� ���� �'S r��� <br /> Signn�urc . . na!� <br /> decepp(!/5/97) <br />