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�- -,� �., � ---- � . <br /> f <br /> APPLICA1 ����1 FOR ELECTR�CAG ; ���IIT <br /> ;tTyrf <br /> e��re��t <br /> BUILDING DEPAFiTib1ENT <br /> ?59-8810 / �'i � <br /> i_j <br /> �i, <br /> ;� ( <06� 3;':�' ?��O <br /> tJ a�� `� -!- / /1 � P� /o.\ <br /> (iwner ..—/�e� �hC S �./1C_. ):-i��' �ciS/,�Ci\'C .�/�/('. � � x v \N�i / �/e �l/� / <br /> i�Mail Address ' Q'���� � ��n <br /> . �tY �P l.ionc � <br /> r.nr a0� �� ddress <br /> ��ty �P F'hnne <br /> ���j�/l C, r�rc �h;<.. I � ^ 7� ` /" �;t� �C.) :� ��) ') -/ `i/ G <br /> � eC[r cJ lontraCtUr �'�� �/�L• / / / � � � / � C. �1 , e . � <br /> �ai .d ro�s ��7/���7 �✓�� i C <br /> q7 lity Tp hone �' i f� <br /> Y -� ,S QC� ' y icense 09/�1��� <br /> �'��i:Je i ;r ' - /� <br /> �ontract�nce o Work t✓Jt.�OI��h �(�I�S��'G� ' �C' CYUrCC ���',���iJ_'��- <br /> c.� i� <br /> raposc se o BuiTi(ing "`' <br /> ro�ect Adtlress r P/• -�-` C � /.V���_ � �'�� il� <br /> .� <br /> �� <br /> �� �� /qf � �O{'➢S � VC / � C < S� . , <br /> Uiscr�pC'an o Wor o Be Uone: <br /> l 6/�S�i�,�"UC GiYI✓Jdi'C� /' Y � C �(, P / ') / �" <br /> , -�-d�C,_��� .r:•,� � <br /> —� <br /> �f <br /> _ - . II <br /> ----- <br /> tIOTE: WAC 296-46-740 REOUIRES THAT P!AIJS FOR ELECTRICAL k'ORK AT E�UCATIONAI,� lNSTITUTIONAL QR HEALTH CARE FACI �� <br /> BE APpROVEU BY TfIE STATE OF' 1YAS�IRIGTON. APPLICAN75 WIT:f SOCII J0�5 tdUST "IC8 THE 5TATE .IPPROVEG p�pNS PEFORE A I <br /> CITY OF EV'cRtIT PER1�11T WILL EE ISSUED. <br /> . I70TE: WIRINC IN NOt!-D'NELLINGS IS REOJIRED 70 GE IN �IETAL RACEYlAYS. I , <br /> ! <br /> I <br /> I HEAEBY CERTIFY THA7 I HAVE READ AND EXA�dINED THIS ��� <br /> APPLL^P.TIGN AND KNOW THc SAME TO BE TRUE AND CORRECI:ALL � <br /> PFOVISIONS OF tAWS ANO GRDMANCES GOVERNING TM�iYr`F OF ! <br /> WOfiK 4YILL BE COMPLFTE� WITH INHETHER SPECIFIED FIEREIN Ofl � <br /> NOL THE GRA�dTING OF A pERHiIT DOES N07 PRESUFAE iv GIVE <br /> AL�THORITI' TO VIOLATE OR CA�ICEL TF;E PNOVISIONS OF ANY <br /> OTHE!3 STA-i E OR LOCAL LAW R[GULATING CONSTRUCTION OR THE <br /> PEFlFORMANCE OF CONSTPUCTION.THAT I AM AUTHORIZED BY THE <br /> ObVNER Cir- THIS PqOPER�fY TO FERFORM THE lNl7NK FOR WHICH �7 � <br /> APPLICATION IS MADE AND I COMPLY WITH THE S7AiE FEE �7�C,r ; <br /> CONTRACTOFS L�W 18.27 RCW AND 296.7.OU WAC, <br /> � 'r ,/�'`�J� 1 C� f <br /> � ' . , <br /> — i.._ � ! .���- /"`�rIC�Lc'�,'_ iX �/��l,/� �!A <br /> � Signature Date ��; <br /> .� t-- i. �,� � <br /> . � �; -=- �� � �: <br /> i <br /> �1 <br /> ..,._. ,. �. .�r, � �:.... <br /> :�.� - ..� 'S .;h,':�. -.' .��;;,:qf aCYM` £Y,..: ,, ,..:._. . .�; - �:.:.r��: � <br /> 7.� <br /> N� �f/is' � � 4� .�(�.. , �. vt45�' . � __ ' ; <br /> � <br /> i,# 1 -5�.'J� ., ),�. :.1- 'u Fi�.�� V� !!l„ . . �n»t� Ak.S? <br /> ,F <br /> u // <br />��Y � . �. � . � n� <br /> �x . � �:r+.. '(�� ��_,� � .yr _.., v_ ���.,w, .. . r.,. �. � _'_ _� . - _ _ . m_ ,.r .a <br /> \l\4�. I� ' l - <br />