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� <br /> APPLICATI� V FOR ELEC i�I�AL � �Rf�IT ` � <br /> C���ci � ✓' <br /> cirv cF �Z—���-/ � <br /> evere'tt '� <br /> BUILDING DEPARTi.1E�dT �7T �_"� <br /> 259-88t0 <br /> Iron <br /> �: <br /> r <br /> � ,{ / ._-' '� iL �� � � <br /> .�� /1 /�'CC �'S ���'� 7/�- 5� '�c��}. . /i.�' <br /> wner <br /> Mail Address Uty �p Phone <br /> G .�, ,r � � <br /> Mail Address ity ip Fhone <br /> enpqt � �., r — <br /> )J.�iNi✓%, �lrc'l i,�c � t: �/,� �/�� /�i�'�/�/�' /c i'��, <br /> �'N" E313 /��l" � �J"= �'Y !•) �/ "•�,f!✓'�� License x <br /> � hone <br /> ectnca ` ontractor—�� Address ��Y P <br /> / .� �� <br /> � �"` �oposed Use ot ui Cing <br /> ontract n ce ot Work - /' <br /> iJ — E: /� F� / � . /� .�/// <br /> /C�� � ' _�/ ' ) 7 G l�t`t'[ r <br /> ro�ect Address � <br /> tscription of Work To 6e Done: <br /> �/tl(� ��/� . n/l��!<((''�l <br /> NOTE: WAC 296-46-140 REOUIRES THAT PLANS FOR ELECTRICAL WORK AT EDUCATIOtlAL, INSTITUTIONAL OR HEALTH CARE FACILITIES <br /> BE APPROVED 9Y THE STATE OF WASIIItIGT04. APPLICANTS 'dITH SUCH JO[35 I4U5T SfiO'd TtIE STATE APPROVED PLnNS BE�ORE A <br /> CITY OF EVERETT PER141T WILL OE ISSUED. <br /> dOTE: 'NIRIt1G R� I�0;1-D'dELLINCS IS R[0�11RED TO L�E It! 14ETAL RACE'9AY5. <br /> I HEREBY GERTIFY THAT I HAVE RC-AD AND [i(AtdINE� THIS <br /> APPLICATION AND KNOW THF SAME TO BE TRUE AND COARECT.ALL <br /> PFOVISIONS OF LAWS AND OROINANCES GOVERNING THIS TYFE OF <br /> VlORK WILL BE COMPLETED WITH WHETH[R SPECIFIED HENEIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR LOCAL Li1W REGULATINC CONSTRUCTION OR THE <br /> PERFOF�dANCE OF CONSTRUCTION.THAT I AM AUTHORIZGD 8'f THE z - `� <br /> OWNER OF THIS PfiOPERTY TO PERFORht THE WORK FOR WHICH FEE <br /> APPLICATION IS MADE AND I COMPLY WITH THE fiTATC <br /> CONTRACTORS LAW 78.27 RCW AND 296.200 WAC. <br /> / ) <br /> X C !�� ��/�`�� <br /> i <br /> i��, . « �� `� �/ <br /> Si,9nature � Date ,: <br /> / �» � I•f <br /> r. <br /> � �,.:.: _ � . <br />