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r <br /> y.�_ . <br /> � <br /> N <br /> � � . APPLICATION FOR ELECTRICAL PERMIT <br /> ~ � � CITY OF EVER[TT <br /> � � OUILDING DIV15104 <br /> 3200 CmAR STREET <br /> y y � EVERETT, XA 90201 <br /> � � <br /> 259-8810 <br /> c <br /> � � � _ ;N,� l,�a, �5o3G 6-zy3r <br /> � • I-/.��2vr=�� r �� 5 5r 9Zo 3q� �,,,sw <br /> � �S <br /> iy �r � TI � Phone <br /> y y �wncr Ma�l Address ��tY - <br /> t+ <br /> N �-- 5�.�. f -- • <br /> N <br /> N �C tate ip Phone <br /> C N enant Mail Address Y <br /> � `� N �/a-rti„�WG �C£li� 8S`�5 /7/ S!�...�5� SrdL.�V... �✓.� ?Y2yo �G�6J7/ �jI75 's�''1 <br /> N �t tate ip hone tate icense o. <br /> ectrical ontractor Mail ddress Y <br /> ,� 2r o �--"�� � CY-O-<<Sl-�...�r` . . <br /> ontract Price oI Work Proposed Use o 6uilding <br /> � ` <br /> �� l� (�t� ��' ,S.L ' , <br /> Project Address <br /> Discription of Work To Be Done: ��'�"� � � <br /> I <br /> I, <br /> r��\ II <br /> � <br /> � �__� — <br /> I <br /> NOTE: WAC 296-46-140 REQUIRES THAT FLANS FOR ELECTRICAL WORK AT EDUCAT�ONAL, INSTITUTIONAI OR HEALTH CARE FACILITIES <br /> � BE APPROVED BY TNE STATE OF WASHINGTON. APPLICANTS WITH SUCH JOBS MUST SHOW THE STATE APPROVED PLANS BEFORE A <br /> i CITY OF EVERETT PERMIT WILL BE ISSUED. <br /> �� <br /> NOTE: WIRING IN NON-DWELLINGS IS REpUIRED TO BE IN CONDUIT. <br /> �I I�1i I HEREBY CERTIPY THAT I HAVE READ AND� EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> � WORKSWILL EFCOMPLETED WIDT'H WHEETH RVS ECNFIED HEREIN OF <br /> � NOT. THE GRANTING OF A PERMIT OOES NOT PRESUME TO GIVE <br /> � . AUTHOFITY TO VIOLATE OFi CANCEL THE PROVISIONS OF ANY <br /> � �' OTNER STATE OF LOCAL LAW REGULAT�NG CONSTFiUCTION OR THE <br /> PEFiFOfiMANCE OF CONSTRUCTION.THAT I AM AUTHOFIZED 8Y THE � <br /> ' OWNEfl OF THIS PflOPERTY TO PERFOFhi 7HE WOFK FOR WHICH FEE <br /> APPLICATION IS MAOE AND I COMPLY WITH THE STATE <br /> I1 1 CONTRACTORS L4W 1827 RGW AND 296.200 WAC. � <br /> � X 7�' ���� <br /> Signature � te ��` � <br /> J J <br /> � <br /> � <br /> � . <br />