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• r•- <br /> APPLICATION FOR ELECTRICAL PtRMIT <br /> c�rv oF <br /> ��� everett <br /> A> � BUILDING DEPARTMENT , <br /> G '� N 259-8810 <br /> 9HV� <br /> y xs <br /> yxH <br /> K n <br /> H� <br /> oxo <br /> htl M �1 nner 1 Ma� dOresa i[y �p �one <br /> �x� � I�- i�' l1�U�ll ��91�i71iC!-. =i7lf-� `ytr,ti'�. �� tc , �i %i�, ��"�' i�,�.� i'=� <br /> p � enant a� �ss ity Zip Pnone <br /> 9 <br /> OH <br /> H �q g ectn ca ontractor ai ress ty p none �cense n <br /> �" n �i /i � J �, i C_\- �-. <br /> c. <br /> H � lwrll�r�����- c � , %�rc,t .� ,r�� �'�n ,��rr��- - r;a> > ���� ,1��i ���v - ,<<-�o� �ra <br /> Z y ontrect r ce o or o sed se o u� eing ` <br /> � H H ;C�o I G�s C,CC� <br /> �y ro)ect a0ress <br /> H <br /> OCa [A ��-r'�l "_��^ ''11�(° ' �l�C' . C U� <br /> [�1 � bisc ip it on`o�Plor o e one: <br /> H o � �G �'i l� -1��, C!,f��`_ ��l i.i'!'lri �f� l'�i'/'r L�� _ <br /> � �-nl-,n ���17i�i I 1 r't <br /> i <br /> I �� <br /> NOTE: WAC 296-46-140 REOUIRES THAT PLARS FOR E.ECTRICAL h'ORK AT EDUCAiIONAL, R;STITUTIONAL OR HE�LTH CARE fACiU TIES <br /> BE FPPROVED BY THE STATE OF WASHINGTON. APPU CANTS XITH SUCM JOBS MUSi SHO'n iNE SThTE APPROPED PLA1�5 BEFORE h <br /> . CITY OF EVERETT PERMIT WILL BE ISSUED. <br /> I �� NOTE: M:RING IN NON-DWELLINGS IS REOUIRED TO BE IN METAL RACEWAYS. <br /> � / <br /> 1� � HEFEBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> '� APPLICATION AND KNOW THE SAME TO BE TRUE AND CORPECT.ALL ���{�� <br /> PROVISION3 OF LAWS AND OFDINANCES GOVERNING THIS n'PE OF �;� Il� <br /> WORK WILL BE COMPlETEO WITH WHETHER SPEGFIED HSREIN OR l � <br /> '� NOT. TF:E GRANTING OF A PERMIT OOES NOT PFiESUME TO GIVE <br /> I� AUTHOA�TV TO ��OLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR TI1E <br /> I PERFOAMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BV iHE <br /> OWNER OF THIS PROPERTY 70 PERFORM THE WOFN FOR WHICH FEE '"lC� ��-'C i <br /> �,_� APPlICA710N �S MADE AND I COMPL� WITH THE STn7E <br /> �� CONTRACTORS lAW 18.27 RCW AND 296.200 WAC. <br /> � �y , <br /> �� ���� � �/ <br /> �^:�1 i'^✓� '7-,r:�_ `/'L <br /> Signature Datc <br />