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APPLICATI��V FOR ELECTRICAL F �RMIT <br /> :irv or <br /> everett <br /> (3UILDII�G DEPARTMENT <br /> 259-8810 <br /> C�7 �1� <br /> p �x //�� (J <br /> .�.i H p� � C Z LTT GO 5 QP\\ N\� S� � �� �.. ( C� /�� j c.–I�J G-7 __ L� � ,��,.. <br /> Unncr a ddress 6 [y ip honc <br /> k�(~j jqw�� <br /> O..y'C O enant ai d ress CY �p mnc 3,qS'c:IS�J <br /> yNH �U r S7 kl.ecCR:c 13�X 379 f�l�e�lt«� ��.� `lg:l7J u.�ESTk'C �ril3L3 <br /> �i <br /> �x� C�[f Cd OOhfdCCO O o dl �1��C55 l L��Y—1��1 1011�- CCf15C .1 <br /> � b s4 000 <br /> O H ConCract r cc o or —� ��� '�� a���nOi�'��"7 <br /> � �g 3 7 1 1 5 ,,,_� Y\. A u� C �� e �z e f Z ul � <br /> �-�j� G 1 o]cct�aaress <br /> x H 3 <br /> ,�.� yz k�-ecTQ�cG�. �f •' "� t�lC `'L' k`Je �E'T�T CroSQcl NL� SS �O �-. <br /> fyy l)iscriptioa of Wor o llc Uonc: <br /> g�' - <br /> � <br /> OC7f� <br /> ��C�1 <br /> ZHtn <br /> HOCo <br /> � <br /> � NOIE: MAC 296-4G-140 REOUIRES TII�T PLAGS FOR EI.ECENICAL WORN Ai E�l1CATi0N�L� ItlSTITUiIOtlhL OR HEALiII CARE FAULITIES <br /> � ._� OE APPROVED �Y TIIE STATE OF WASIIIt1Gi0N. 11PPLICA17T5 WITII SUCII JOUS IIUST SHOW IIIE STATE APPROVED PL�NS OEFORE A <br /> `_ CIiY OF EVEREiT PERMIT WILI OE ISSUED. <br /> NOTE: WIFING IN NOtI-DN'ELLINGS IS REOUIRED 70 OF It7 HC'IAL RnCEh'AYS. <br /> I _ <br /> � <br /> I HEREO� CERTIFV TH�T I IIAV[ READ AND E%AIdINEU TIIIS <br /> . APPLICATION AND NNOW 1H[SAldG TO�E 7RUE AND COf7RECT.ALL <br /> _ PfiOVI510N5 OF LAW3 AND ORDINANCES GO�ERNING 7HI5 7VPE Of- <br /> VlORK WILL BE COMPLETED WITH WHE711ER SPECIFIED HEFlE�N Ofl <br /> �1� NOT. TNE GRANtING OF A PEfiMIT DOES NOT PRESUME 70 GIVE <br /> � AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANV <br /> OTHER STATE OR LOC�L U1W t1EGULATING CONS7RUC110N OR TNE <br /> PERFORMANCE OF CONSTRUGiION.THAT I AM AUTNORIZED BY iHE _�� }- <br /> � OWNER OF THIS Pf10PERiV 70 PEfiFORM THE WOf�K FOR W�IICH Ff.E _ " <br /> 1�� APPL�CATION IS IAADE AND I COMPLY WI111 i11E STA1E <br /> CONTRACTORSLAW1027RGW �D29G200 W�C. <br /> c <br /> ��� <br /> �� X ,L.�L� .�/�L_�—_� — <br /> � $ignaturc � " Date �� :-�-., 'f. <br /> : , <br />