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�IL�} APPLICATI"� FOR ELECTRICAL. 1 �RMIT <br /> an eF �� <br /> evere#t <br /> �WLDING DEPARTMENT - <br /> 259-��10 <br /> �1 <br /> �A � �w �� ,.,�-� ''.a i.��..�W�1nAvii �.�� .�c.a� I���IcI—�-�'G)�?S°- 37`au <br /> �er � Ma� Addresi ty �p PM1onc <br /> enan[ ai �dress iCy ip �one <br /> r'Itbr �i� AJ✓i� a„�...P I� O.�xn-/��/1R �-� �cc��� ( UA 98C3L (lul-)7'�G�i55� 1 �� k/criZcy�$' <br /> Elee[r�ca lonGrac[a� Ma�� l��tlrose�-��hone icense C <br /> lantraeC � cc o Wa� ropoleq :e o u� J�n9 <br /> � 1� �4�� 1� �' ��A�.')G �40� Vo��= �Q(�n� C�;i���W �,��A . �LLOI <br /> ro�ee[ AOOress <br /> Uiscnpcion ot aor�: a tl(e� onr. <br /> YPrn� Nc,p �fUN���.J <br /> A�l. �4..eScc,���,E� �u`�#�U `���5 UL��" Y9nr: �v�,-��•I-4� <br /> IlOTE: MAC 29fi-46-140 REOUIf.ES TW1T PLANS FOR E�ECTRICAL NOflK AT E�IICPTIOtIPL� INSTITUTIONAL OR HEALTH CARE FACIIITIES <br /> OE APPROVEO DY 1HE STATE OF NASIIINCTON. APPLICANiS MITII SIICN J0115 HUST 5lIOM TfIE 51ATE APPIiOVED PUNS OEFORE �1 <br /> CIiY OF EVEflETT PE2MIT WILL �E ISSIIED. <br /> t1UiE: WIRIIIG III NON-GwELLItIGS IS REOUIftED TO UE IN METAL RnCENAYS, <br /> I HEREBV CERTIFV THAT I MAVE flEAD Al1D E%AlAINEO THIS <br /> APPLICATION AND KNOW THE SAlAE TO 6E TRUE ANU CORRECT.ALL <br /> PROVISIONS Of lAWS ANO Of��INANCES GOVERNING TMIS TVPE OF <br /> WOftN\vILL BE COMPLETEO Y/iTM Y+HETt/ER SPECIPIGD MEREIN OB <br /> NOT.THE Gf1ANTING OF A PE91d1T DOES NOT PRESUh1E TO GIVE <br /> AUTHONTY TO VIOLATE OR JANCEL THE PROVISIONS OF ANV <br /> OTHER STATE OR LOCAL LAW flEGULAiING CONSTRUCTION Ofl THE <br /> PEfiFOflMANCE OF CONSTRUCTION.THAT I AM AUTNOflIZED DY THE d / T <br /> OWNEfI OF THIS PROPERTY 10 PEflPOR1A THE WORN FOR WHICH FEE i� /._ �J.L'L: <br /> APPLICATION IS MAOE AND I COMPLY WITH THE STATE <br /> CONTHACTOiiS LAW�827 RCW AND 29G.^.QO WAC. <br /> r. <br /> X � � � <br /> ���r.-.��._ � 3�tA.�_C,��� / /� 9,� <br /> 5(gnature J Date <br /> .���"L1�. <br /> � <br /> - : -- � _ � <br /> ���� � �� - <br /> �. � _ <br /> �P ..MFi le_: . . - �:.��. .0 �. �. � <br />