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....�.. � .._ _ � _ -�� _ <br /> APPLICAT, �N FQR ELECTRICAL , ERMIT <br /> ��n oF i <br /> evQre#�t <br /> BUILDING DEPARTMENT � <br /> 259•PBiO <br />� � <br /> `� �„11�, `,`,�,r, � ` ;:�I�,•� ��.;In4e ��: �t� '�L,-�� �.�t.'�-�Ir �i„I���� � �i��;) ��J` '��7�-�(� <br /> Owner 11ai Address ty ip hone I <br /> r.nant ai, ddress ity ip hone <br /> c <br /> �� :,k�c. �I�r�� �c i t C��( �o� l�l� t i 2 ✓v � 5' <br /> . ETectrica�—Zontractor Mai ddress ty p hune tcnnse 0 — '�, <br /> � J ,J�� . ��U . <br /> ontract n cn o Wor ��rop�se o u� Jing <br /> �1C� `� IS+ ��C.CL <br /> ro��ct AP ddress — <br /> iscription o 'Nork o dn ona: <br /> c� <br /> �JPvJ rJc�l� nn� 7 '�in-\. F�G �,� ��� -i� n `��c�Oncc <br /> NOTE: WAC 296-46-140 flEOUIRES THAT PV�NS FOR ELECTRICAL WORK AT EDUCAT�ONAL, INSTITUTIONAL OR HEALTti CARE FACILITIES <br /> OE APPfiOVED BY TNE STATE OF WASFIINCTON. AV'PLICA11T5 WITH SUCN JOtlS HUST StION THE STATE APPROVED PLANS OEFORE A <br /> CITY OF EVERETT PEf1Fl1T WILL OE ISSUED. <br /> tIOTE: WIRINC IN NON-DWELLINGS IS REOUIRE� TO OE IN METAL RACEWAYS. <br /> I HEREBY CERTIFY THAT I HAVE flEAD AND EXAMINED THIS <br /> � APPLICATION ANO KNOW THE SAME TO BE 1'RUE AND CORflECT.ALL <br /> PFOVISIONS Of LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> WORK WILL BE COMFLETED WITH WHETHER SPECIFIED HEREIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> � � AUTHO(iITY TO VIOLATE OR CANCEL TH[ PROVIS�ON5 OF ANY <br /> OTH[R STATE OR LOCAL U1W REGUTATING CONSTFUCTION OR THE <br /> PEfiFORMANCE OF CONSTflUCTION. THAT 1 AM AUTHOR¢ED BY THE �_ C�l� <br /> OWNER OF THIS PROPEHTY 70 PERFOFM THE WORK FOfl WHICH FEE ��J <br /> APPLICATION IS M�DE AND I COMPLY WITH THE STATE <br /> CONTflACTORS LAW 10.27 RCW AND 296.2D0 WAC. <br /> X � <br /> � � ��� _ ��,, . �,( ��1������ F;�; 3 <br /> � � c <br /> Signature �� <br /> �/n I y � <br /> I <br />