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ELE(�TRICAL PERMIT Q^'PLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 <br />�C� / S .S'1 y1 5-<- T C-�, n-G Y C�c �c 1 f <br />PROJECT ADDRESS <br />`�oJ S�1 6i�2 Sv�s .S:,�sef L�,nc �cc;�-tt <br />Gv:ncr <br />Tenant <br />tdail Address <br />h1a�l Address <br />Ciry <br />Ci�y <br />State.2ip <br />State2ip <br />�Z-o2-oz <br />�D �/2 -°�3 <br />Phone <br />Phone <br />7,�-C,.,� 4i«lr,�_ 1N3iL L3Sr� „�.6�.,,.sti 9'�Z <br />5151' S� `/� �/7S ;395'•9143 <br />Electncal Contractor Mail Address City State2ip phone <br />State License Number <br />/`�r�fU�� �, c r <br />Pranosed Use ol Building <br />Contract Pnce ot Work <br />%✓•.� �'/i^sn�«.-� <br />Contact Person (Plan Review) <br />Description ol Work to Be Done: (,�„��,,,5 r/ %�YU $�, F! ,/��/�I, f. c y� <br />NOTE: PLr1NS FOR ELECTRICAL WORK AT EDUCATIONAL. FACILITIES UTILIZING STATE FUNDS MUST BE <br />APPROVED BY THE STATE OF WASHINGTON. APPLICANTS WITH SUCH JOBS MUST SHOW THE STATE <br />APPROVED PLANS BEFORE CITY OF EVERETT PERMIT WILL BE ISSUED. WAC 296-46•140. ALL OTHER <br />EDUCATIONAL FACILITIES AND ALL HEALTH CARE FA(;ILITIES P�ANS W ILL BE REVIEWED BY THIS OFFICE. <br />NOTE: WIRING IN NOtJ-DWELLINGS IS FEQUIRED TO BE IN RACEWAYS, MC OR AC CABLE. <br />HANDICAPPED ACCESSIBILITY: ELECTRICAL AND COMMUNICATIONS SYSTEM RECEPTACLES ON WALLS <br />WITHIN ACCESSIBLE SPACES OR ALONG �1CCESSIBLE ROUTES OF TRAVEL SHALL BE MOUNTED A MINIMUM <br />OF 15 INCHES ABOVE THE FLOOR. WAC 51-20 SEC. 3106(c)2. <br />ENVIRONMENTAL AND OTHER C01 "ROL RECEFTAC�ES AND OTHER OPERABLE EQUIPMENT WITHIN <br />ACCESSIBLE SPACES OP ALONG ACCc5518LE ROU7ES OF TRAVEL SHALL BE �-10UNTED WITHIN THE REACH <br />RANGES OF WAC 57-20 SEC. 3106(b)4 E& F AND NOT LFSS THAN 36 INCHES ABOVE THE F�OOR. <br />1 NEFE9Y CEFTIFY iHAT l HAVE FEAD ANL EXAhfINED THIS APPUCATICN aND RNCW iHE SAM11E TO BE TFUE AND COFFECL ALL <br />PFOVI570NS OF LAIVS AND CFCINANCES GCVEFNING THIS i 1'PE OF WCFK WI�L 6E COMPLcTED WHETHEF SPcGF1ED HEREIN CF <br />NOT TNE uFANT6VG OF A PEn'hll r pCES NOT ?FESL'hfE TO GIVE AUTHCFI i Y r0 VIOL1 Tt CF C4NCEL i HE PFOVISICNS CF -0NY OTHEF <br />57ATE CF LCCAL L4L'✓ FEG�WTIlVG CCNSiFUCTICN OF ihE PEFFCFAfANCE JF COV57FUCTIGN. iHAT I AM AUTHCFI�ED 6Y iHE <br />Cll',4EF OF THIS PFOPEF7Y TO PEFFOFM1f THE WOFK FJR bl'HICH APPLICAiION 1S MAOE ANO I COM17PLY W/iH THE StATE <br />C:'NTFAC7CF�S G1 W iy.`2? FCbV AND ZP6.000 WAC. <br />'/ / � <br />. i � .� / <br />i <br />� '%/ <br />'�_ �� L ���� /c L FEE �� JV <br />`- � �J J <br />Signature Date <br />ELECAPIREVB�2CJ7) <br />L C� ,�� �.-- ��0=3 <br />