Laserfiche WebLink
� r � <br /> m <br /> H <br /> C H <br /> � H � <br /> H � H <br /> � H � <br /> � H '� <br /> � o � APPLICATI�N FOR �LEGTRICAL , .:l�MIT <br /> H C7 <br /> OH <br /> � � g <br /> �V nC <br /> Cy2Z H 3 Cptiv`C,F r} <br /> L Y Ll �:lL <br /> g c~n y 3UILDING DE?AFT�IENT <br /> � b� 259•8810 � <br /> :� � � <br /> ij � ��(i <br /> �'. Hm <br /> HOcn <br /> � �r�fe n r�;i�c �-� - /� 5�iy'- �in �"'` /'r��' S, E• fl�P/'PI� 1���, %�'�7U��- 7�!..�-i%G �`- <br /> wner L Mai� �ddress �ty Zip hone <br /> l�/� C`RnJ / � — <br /> �nt Ma� tlOress �ty Itp � <br /> 1 i <br /> i�Ci.�/� l�'c�/'i .��/S� �/.'O�xt'i2 ��Paf .C�J. `1�.�--'/��5-�7- S�k"9J-/'i'c��i,v,-�/7rYf <br /> ecCnca ontractor hlai�Atld�e55-��ty ^° rtp hone ttense +' <br /> !�'P �/C/'F/U r//f � <br /> ontract n ce or 'dork � roposea—Osu or ui ding <br /> .J/— S�G> T/, s f S GC./ f;.J r�2-�� <br /> ro�ect tldress / <br /> Ll/iP '� N � uJ ✓tGu C PN !> .Z•iJ�iTf.'C.C. �O�', �'�hn St'!LU rC �p_ � <br /> Uisc�i�tian of Work i'o�e one: r <br /> 1 ' <br /> 'o/ <br /> I'1 <br /> ea/ <br /> �� — <br /> �� NOTE: WAC 296-46-140 REOIiIRES THAT PLAI15 FOR ELECTRICAL WORK AT E�UCATIONAL, INSTITUTIONAL OR HEr1LTH CARE =hCILITIES <br /> � BE APPROVED BY THE STATE OF WASHINCTON. APPI.IGINTS WITH SUCH JOBS MUST SHO'A THE STA7E APPROVED PLANS BEFORE A <br /> CITY OF EVERETT PERNIT 'dILL 6E ISSUE�. <br /> 1 NOTE: WIRING IN NON-DWELLINGS IS REOUIRED TO BE IN FfETAL RACEWAYS. <br /> r� <br /> ►' <br /> I HERE81' CERTIFY �iHAT I HAVE READ AND EXAM�NED THIS <br /> � APPLICATION AND KNOW THE SAME TO BE TRUE AND COFRECT.ALL <br /> I�' PROVISIONS OF LAWS AND ORDINANCES GOVEFNING THIS NPE OF <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> �� NOT. THE GRANTING OF A PERMIT DOES NOT PFlESUME TO GIVE <br /> AUTHOFITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> � OTHER STATE OR LOCAL LAW flEGULATI4G CONSTRUCTION OR TriE <br /> aO PERFORMANCE OF CONSTRUCTION.THA71 AM AUTHORIZED BY THE ,� <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH FEE �5�, ��G <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 1827 RCW AND 296.200 WAC. <br /> �` � � ,�— C,' �l <br /> Signature� Date <br /> ���l�r' <br />