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.a, r. <br /> APPLICATION FOR ELECTRICAL PERMIT <br /> C1TY OF EVERETT <br /> BUII.DING DMSION <br /> 37A0 CEDAR STREET <br /> EVEEtfiTf,WA 98201 <br /> 259-88f0 <br /> ��.,���,� //23z/�Je�.rau t� C�i� �Q 334 8d'3Z <br /> Ownu Mai! Address City State/Zip Phone <br /> Tmant � Mail Address Ciry Slate/Zip Phone <br /> 71� ��a�i9C�vsZan/fi�.ls�ur�(o�a �%�►��i �P6-G8t33 <br /> Electrical ContncWr Mail Address Ciry Sta ip Phone �S��cease .�o�.�! <br /> 0. /r�u.I �"7` <br /> Contracc ce of Work Proposed Use of Building <br /> L� xez� <br /> Projxt A rcss <br /> Description of Work W Be Done: ���.�2i�1 GY�AtiU`Y19//h��N' 4/�.i . I/S�/S� <br /> NOTE:WAC 296-46-140 REQUIRES THAT PL.ANS FOR ELECTRICAL WORK AT EDUCATIONAL, WSTITU'170NAL OR <br /> HEALTH CARE FACII.IT�S BE APPROVED BY Tf� STATfi OF WASHINGTON. APPLICANfS WfI'H S[TCH JOBS <br />� ' ' MUST SHOW Tf�STATE APPROVED PLANS BEFORE C1TY OF EVLRET PERIvIIT WILL BE ISSUED. <br /> I �� <br />; A . NOTE:WQtING IN NON-DWELLWGS IS REQUIRED TO BE IN METALLIC RACEWAYS (MC AND AC, ARE CABLES, <br />� t' NOT RACEWAYS). <br /> i _ <br /> I r <br /> , I FiEREBY CERTIFY THAT I HAVE READ AND EXAMINED TFIIS APPLiCATION AND KNOW Tf�SAMH TO BE TRUE <br /> AND CORRECT. ALL PROVISIONS OF LAWS AND ORDWANCES GOVERNING TfiIS TYPE OF WORK WII.L BE <br /> COMPLETED WI'I'H WHET'HER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME <br /> TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATfi OR LOCAL LAW I <br /> I , , REGULATING CONSTRUCTTON OR THE PERFORMANCE OF CONSTRUCITON. THAT I AM AUTHORIZED BY THE � <br /> OWNER OF THIS PROPERTY TO PERFORM T[�WORK FOR WfiICH APPLICATION IS MADE AND I COMPLY WITH <br /> THE STATE CONTRACI'ORS LAW 18.27 RCW AND 296.7A0 WAC. i <br /> " �k�ii y'/z��93 Fa <br /> Signamro , Date <br /> c j��[/-Z/t-O oS—OoO� � (� <br /> ��) ��«�rv o�sro» <br />