Laserfiche WebLink
� <br /> z <br /> � �y j APPLICATION FOR �LECTRICAL 1'�RMIT <br /> [ � H <br /> � Hfn <br /> C17'Y OF EVEitLTT <br /> y H BUILDING DMSION <br /> � y � 3200 CLDAR STREET <br /> ,0 N ,� gVERETT,WA 95201 259-8810 <br /> V7 H <br /> Q �-�+ ��y ,��GECT F�OIL,ES <br /> h�i C�11 p Owner Mail Address Gt}' SL•.telZip Phooe <br /> �r n <br /> Xy� <br /> � y H T���� - � � Mail Address City SL�te/Zip � Phone <br /> 8 � <br /> C]C7 V� <br /> � �� .CH�3 <br /> � �� Llectrical Contracror Mail Address City � State/Zip Phone State License No. <br /> � �v00.Po ,r�..i i.�ol:i <br /> Contract Price of Work Proposed L'se of IIuilding <br /> i LoT S 2 S8/O /3T �Ij, l✓EST <br /> � � � Projcct Address . <br /> � Dcscription of 14ork to Be Donc: <br /> `_ <br /> � 1 <br /> �� '�' � - NOTE:WAC 296-06-140 REQUIFtES THAT PLANS FOR ELECTFLICAL NORK AT LDUCATIONAL, INSTlTUTIONAL OR <br /> � HEALTH CARE• FACILITIES BL APPROVED IIY THL• STATE OF \VASHINGTON. APPLiCANTS W1TH SUCH IOBS <br /> MUST SHOW Tf�STATE APPROVED PLANS BEAORE CITY OF EVL-RLT PLRIdIT NILL➢E ISSUED. <br /> �,s NOTE:\VIRING IN NON-DWLLLINGS IS REQUIRED TO BL IN 1.1ETALLIC I2ACE\VAYS Q.1C AND AC, ARE CAIILES, <br /> NOT RACLWAYS). <br /> '�� I FiHREBY CERTIFY THAT I HAVE READ AND EXAMWED TFIIS APPLICA'I'ION AND KNO\V THE SAMG TO DE TRUL <br /> I � AND CORRECT. ALL PROVISIONS OF LANS AND ORDINANCES GOVERNING 7'HIS .TVYE OF WORK WILL BE <br /> \ COA4PLL•1'GD WITH WHETHER SPECIFIED FiERGIN OR NOT. THti GRAN'CING OF A PL•RAfIT DOES NOT PRESUMG <br /> TO GIVE AUTHORI7'Y TO VIOLATE• OR CANCEL THE PROVISIOiQS OP AflY O'.HER STATE OR LOCAL LAW <br /> REGULATING CONSTRUCTION OR THE PGRFORA1ANCE OF CONSTRUCTION. THAT I ATi AUTHORIZED IIY THE <br /> OWNER OP THIS PROPERTY TO PERPORi�f THH N'ORIi POR R'HICH APPLICATION ]S MADE AND I CObiPLY WITH <br /> THE STATE CONTRACTORS LAW 18.27 RCW AND 29G.200\4AC. <br /> � ZtJ..�.CC%ai.— G� ��e2{c� �`L2�Y3 Fee �$S� <br /> Signature . D��� <br /> elecnpp(J1519J) <br />