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v I _� <br /> APPLI�AT�N FOR ELECTRICAL�'°ERMIT I <br /> �I <br /> LITY OF I <br /> ��� ever�tt <br /> y y 9UILDING DEPARTMENT <br /> C�H ?59-8810 <br /> a��n <br /> M 3 <br /> �` y� �• ,��_Q�CL I � 4 ;�' E' �e� Z�Z4� - <br /> O x O .�� n�� Atltlress ��ty tp hane <br /> 'il H"i1 A.ner <br /> U1 H <br /> � Zp� Ha� AEtlress � ty �p hone •. . <br /> H C7 ,� <br /> , I r /1 �( c ( 7 •L�v � �� G3C7�� I <br /> � �g � �IL� 'I�C11�lClItiL^ 3�� I`��- `�'�-� �`3I'1I1 rC �5�� ., hone �censea <br /> �ica lantractor Meil AEOress ��� °�P <br /> M� � b ��,� ._ 5��. <br /> lontraCi rice a Nor rOpOsetl Use at u1 ding <br /> rHy ,1 , %'o '�% <br /> � y ro)ect Aearess <br /> H <br /> (q7 C❑7(/� <br /> 3 C+1[" tscripttyon o eor o e ane: , <br /> M [�f `�1.��'� �l � � n '1 C i � � . <br /> H O t�i� � <br /> il <br /> i <br /> � � <br /> ! ! NpTg; 'tlAC 296-46-140 REOUIRES THAT PUNS FOR ELECTRI�.iI WORK AT EOUGITIONAL� INSTITUTIONAL OR HEALTH CARE FACILITIES I <br /> 0E APPROVEO BY THE STATE OF WASHINGTON. APPIIGNTS WItH SUCH JOBS MUST SHO'A THE STATE APPROVED PUNS BEFORE A I <br /> CITY OF E'lERETT PERMIT 'AILL BE ISSUED. I <br /> � i <br /> � � NOTE: 'MIRING IN NON-DWELLINGS IS REOUIRED TO BE IN McTAI. RACEWAYS. � �, <br /> i <br /> �I ^ I <br /> � W <br /> '��' � HEPEBY CEHTIFV THAT I HAVE READ ANO EXAMINED THIS �j�� . <br /> APPLICATION AND KNOW THE SAME TO BE TRUE ANO CORFECT.ALL <br /> PROV�SIONS OF LAWS AND ORDINANCES GOVERNING THIS NPE OF ,, <br /> WORK WILL 8E COMPLETED WITH WHETHER SPECIFIED f'EREIN CR <br /> !(! NOT. THE GRANTING OF A PERMIT OOES NOT PRESUldE TO GIVE ' <br /> AUTHOFITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR IOCAL LAW REGULATING CONSTRUCTION OR THE � <br /> PERFOFMANCE OF CONSTRUCTION.THAT I AM AUTHOR�ZBD BY THE �r(%0 �. <br /> ..,, � OWMER OF THIS PFiOPERTY TO PERFORM THE WORK FJR WHICH FEE �1 <br /> APPLICATION IS MA�E AND I COMPLY W�7H THE STATE � <br /> CONTRACTO IAW 19.27 RCW AND 296.200 WAC. <br /> '~,� /� ( .' <br /> X �— �f '�� C � � <br /> I <br /> ,� Signa[ure � Uate <br />