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ELECT� �ICAL PERMIT APf� �ICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 <br /> �/,`Z S'/c�./�,e U r i✓t <br /> PROJECT ADDRESS p�� <br /> Q�s� �.- /� S,F ,�e ��ivp C�ve�ff (�c� r <br /> Owne� Mail ACdress Ciry SWtelZip Phona <br /> Tenant Mail Address Ciry �,�f�'� State2ip Phone <br /> �� 3�0 <br /> %�/o .���o�+c/ �� �� �� I�O �a�c �% �✓ � �1 ��� � v?1=E� �Z <br /> Electrical Contractor <br /> Mail Adtlress Ciry Stete2ip Phone <br /> �2 U ����'� 7�'�� Contract Price of W ork <br /> State License Number <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of W ork to Be Done: ��C�' -F /rC c �ff �' ��� " �'�t�" <br /> P q r iT� P•,. � G t i^P r �'cfC��o LP <br /> � <br /> NOTE: PLANS FOR ELECTRICAL WORK AT EDUCATIONAL, FACILITIES UTILIZING STATE FUNDS MUST BE <br /> APPROVED BY THE STATE OF WASHINGTON. APPLICAiJTS WITH SUCH JOBS MUST SHOW THE STATE <br /> EDUC�ATIONAL FACILITIES AND ALL�HEALTH CARE FACILITIESI PLANS WSLLE E REVAEW ED BY THIS OFFICETHER <br /> NOTE: W�RING IN NON-DW ELLINGS IS RE�UIRED TO BE IN RACEWAYS, MC OR AC CABLE. <br /> HANDICAPPED ACCESSIBILITY: ELECTRICAL AND COMMUNICATIONS SYSTEM RECEPTACLES ON WALLS <br /> OF 16 NCHES ABO E T ECFLOOR.AW C S1A-20 SECI 3106(�2TES OF TRAVEL SHALI BE MOUNTED A MINIMUM <br /> ENVIRONMENTAL AND`-OTHER CONTROL RECEPTACLES AND OTHER OPERABLE EQUIPMENT WITHIN <br /> RANGES OF WAC SE 20 S C�3N06(b)4CE& FI ANDRNOT LE S THAN 36LINCHES ABO EUTHE�LOOR IN THE REACH <br /> 1 HEREBY CEATIFY THAT 1 HAVE READ AND EX.4MINED THIS APPLICA710N AND KNOW TME SAME TO BE TRUE ANO CORRECT. ALL <br /> PROVISIONS OF LAlYS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLETED WHETNER SPECIFIED HEREIN OF <br /> NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO GI VE AUTHORITY TO VIOUITE OF CANCEL THE PROVISIONS OF ANY OTHER <br /> STATE OF LOCAL LAW REGUL4TING CONSTRUCTION OR THE PERFORMANCE OF CONSTFUCTION. THAT 1 AM AUTNORIZED BY THE <br /> OCONTRA�OFSILAW�9.27RCWAND296200WAC.E WORK FOF WHICH APPLICATION IS MADE AND 1 COMPLY WITH THE STATE <br /> FEE <br /> Signature Date <br /> ELECAP�REV Bf2001) �d�// — ��� <br />