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APPLICATION FOR ELECTRIC.4L PERI�IIT <br /> CITY OF EVEREn' . <br /> BUiI.DING DMSION <br /> 7200 CEDAR STREE'I' <br /> EVEeZE'i'f, WA 98201 <br /> 259-88i0 <br /> , UJqv�e r'.� <br /> —�� .L � ti�(1 �`� -� . Inr �il �� 0 _LC�JI . <br /> Owner Mail Addrsc <br /> City Stste/Zip Phone <br /> �Z�ILI�UC <br /> Teaaot . .. Mail Address <br /> ' CitY State/Zip . Phone <br /> ���la�o o n es� 11 p�,t�Y�r�C ��g S!���- n�� �5l QS�a�m � r�,�. <br /> Electncal '�ntncto MaJ Addras C�ty Sute/�: Pbone <br /> �p p State Licease No. <br /> I � • �1. <br /> Cootract Pnce of Work Proposed Use or Buildmg <br /> ? Projxt Addras <br /> � Description of Work to Be Dooe: i�(�p <br /> ' � vT' <br /> ' 1'�'�-� ,g��l - �/� <br /> �.:.. �-------,�_—.�. <br /> ; YOTE:WAC 296-46-140 REpUIREg TH��T PL.-4\'S FOR eLCIr,iG�i, ��'ORF: AT EDUCATIOiJAL, IIJSTI1UT;pNAL OR <br /> FiEALTH C,�RE FACILITIE$ gE qppROVED BY T.FL. STATE Or �V.qSFST7GTON. APPUCAMS WITi-I SUCH JOBS <br /> DiUST SHOW TfiE STATE AppROVED PL,WS BEFORE CITY OF EVEfL�.T PER1�fIT 1VII..L BE ISSUED. <br /> : NOTE:WIRp1G W NON-DWELLINGS IS REQIJIRED TO BE C� \fE'CALLIC R4CFWAYS (MC AND AC. ARE c ,ABLES.' <br /> ' NOT RACEWAyS). <br /> � <br /> I :�REBY CERTIFY THAT I HAVE IZEqD qND gXe�.fL`!ED 'I"-!TS :1?PLIC:17'TCN,WD KNOW Z'H" S,\A.fE TO BE'i'RUF � <br /> ?.ND CORRECI', ALL PROVISIONS OF LAWS ATID ORDL`1,a,uCES GOVL•RNING THIS TYPE OF WORK WII.L BE <br /> COMPLETED WIZ'H �V�[�� SPECIFIED I-CREi;J OR NOT. T:?c G�,\NtI.tiG OF A PERI�iIT DOES NOT PRESUME- <br /> TO GNE AUTHORI'iY TO ViOLATE OR C.�IJCEL TH?S PROVISIONS UF ,WY OTHER STATE OR LOCAL LAW <br /> REGIJL.ATING CONSTRUCI'!ON OR THE FEt2FORtitANCE OF CONSTRUCi'ION. T?tAT I AAt AUTHORIZED BY T7-L� <br /> OWNER OF TFII� pROPERTY TO PERFOR'.! TI� WOR.� FOR `.47?ICH APPLICATION IS MADE AND I COhiPLY WITfi <br /> i�iE STATE CONTRACI'pRS LAW 18.27 RCW AND 296.2C0 1VAC. <br /> Y �- ` <br /> � , � <br /> Signiture � F� <br />