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�_'�"'��^ .. . _�.�__._^..�fr -__.� . � <br /> I <br /> ANPLICAT�,�N FOR CLECTRICAL � �RMiT ������ <br /> CITY OF <br /> evere#t <br /> BUILDING DEPARTMENT <br /> 259-BB10 ' <br /> �T <br /> o ���1��`", `�\,n [/�D�a�;h � i�y e [ c� ��q�-I.l (ti'`'6I0 Z, / \ <br /> ���i nadress � `�"��13c�$ '3��Q <br /> �y Z�P Phone -- <br /> r.nant ai ddress I <br /> ,��I- "��Y �P hona <br /> K�. � . .5/f�C �'-.^ �, <br /> . tlectr�cal 6ontrac[or Mat i�ddress , �� O��c�g.,� �L�J�� <br /> ��Y �P ho/n�r icense # <br /> ontruct nce a Wor � I 1 \ ' <br /> I � �1,. �1 �Q � ropased se o u� ding � <br /> �II � �-Q �`��` \., `�� <br /> `( ' �Qn ] � � <br /> pro� ct Address � OT � <br /> iscriptian or 'Nork o de DoneL_ �` <br /> 1 Q, -� ,1-�_ <br /> NOTE: WAC 296-46-140 REOUIRES THAT PLANS FOR ELECTRICAL WORK AT EDIICATIONAL, INSTITUiIONAL OR FiEALTH CARE FACILITIES <br /> OE APPROVED OY THE STATE OF WASHINGTON, APPLICANTS WITH SU=N J005 11UST St1UW Tf1E STATE ApPpOVED PLANS BEFORE ,: <br /> CITY OF EVEflETT PERMIT WILL BE ISSUED, �� <br /> IIOTE: WIRINC IN NON-DWELLINCS IS REOUIftED TO �E IN MEiAL RACEWAY:, I' <br /> 1 HEREBY CERTIFY THAT I HAVE READ AND I <br /> APPIICATION AND KNOW THE SAME TO BE TRUE AND CO AECT.ALL <br /> PROVISIONS 01'LAWS AND OFDINANCES GOVEqNING THIS TYPE OF <br /> WORK WILL BE COMPLETED WITN WH[THEfl SPECIFIED HEREIN OR � <br /> NOT. THE GRANTING OF A aERMIT DOES NOi PRESUME TO GIVE <br /> FUTHORITY TO VIOL�:TE OR CANCEL THG PROVIS�ONS OF ANY � <br /> OTHEFl SiATE OR LOCAL LJ1W REGUTATING CONSTfiUCT10N Ofl THE I� <br /> PERfORMANCE OF COIJSTRUCTION. THAT I AM AU7HORIZEO BY THE �y�-��� <br /> OWNER OF THIS PAOPERTY TO PERFORM THE WORK FOR WHICN FEE µ� <br /> APPL�CAiION IS MADE AND I COMPLY WITH THE SiATE <br /> CONTRACTOFlS LAW 18.27 flCW AND 29G.200 Y:4C. <br /> X `\)�k�.�l, ��� lz�i��l�i� <br /> Signature �ate <br /> _'. . m-= ___ . _.—._—__. ._<�-.eL_ _..�� <br />