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�, <br />APPLICATION FOR ELECTRICAL PERMIT <br />CIIY OF Et'ERE7i <br />6UILDING DIVISION <br />3200 CEDAR STRFEi <br />F.VERETT, WA 982Jf <br />PHONE: (425125 7-88 1 0 <br />F,q)(: (425)257-8857 <br />v,n C� 5( s� �i s �(..) <br />s L-1.�— <br />PROJECT ADDRESS <br />�_ ._� I 1 --�,�,,.. ,. � �,rk�c7 — 5l s� P�- S cv <br />Oemer <br />Tenant <br />Mail Address <br />Mai� Address <br />e cJ tXapJGt.�. 1��c <br />Contreclor Mail Atldress <br />Lc.h E cv f• r, ��d �J <br />State License Number <br />�,�/ ��-�- <br />Proposed Use f Building <br />Description of Work to Be Done: <br />City <br />Cily <br />�fJ B� <br />State2ip <br />Stale/Zip <br />Phone <br />Phone <br />T�S�- <br />Ciry State2ip Phone <br />�{ � ��a��%-�t�j � <br />�S� � <br />Contract Price of Work <br />Contac! Person (Plan Review) <br />NJTE: PLANS FOR ELECTRICAL WORK AT EDUCATIONAL, FACILITIES UTILIZING STATE FUNDS MUST BE <br />APPROVED BY THE STATE OF WASHINGTON. APPLICANTS WITH SUCH JOBS MUST SHOW THE STATE <br />EDUCAT ONAL FACILBITIE�S AND ALL �HEALTH CARE FACILITI SI PLANS IWSLLEBE REV EW ED BY THIS OFFI �THER <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO BE IN RACEWAYS, MC OR AC CABLE. <br />HANDICAPPEG P.CCcSSIBILITY: ELECTRICAL AND COMMUNICATIONS SYSTEM RECEPTACLES ON WALLS <br />WITHI�I ACCESSIBLE 3PACES OR ALONG ACCESSIBLE ROUTES OF TRAVcL SHALL BE MOUNTED A MINIMUM <br />OF 15 INCHES ABOVE THE FLOOR. WAC 51-20 SEC. 3106(c)2. <br />ENVIRONMENTAL AND OTHER CONTROL RECEPTACLES AND OTHER OPERABLE EQUIPMENT WITHIN <br />RANGE6 OF WAC 5E 20 SEC. 81 6(b 4 E& FI AND OT EESS THAN 36LINCHES ABOV�E THE �F OOR IN THE REACH <br />I HEREBY CEATIFY THAT ! HAVE READ AND EXAMINED THIS APPLICATION AND KN04V TF1E SAME TO BE TAUE AND COFRECT. ALL <br />PFOVISIONS OF LA4V5 AND OROINANCES GOVERNING THIS TYPE OF WORK W/LL BE COMPLETED WHETHER SPECIFIED HEREIN OR <br />NOT, THE GRANTING OFA PERIvIIT DUES NOT PRESUME TO GIVE AUTHOAITY TO VIOL:ITE OP CANCEL THE PFOVISIONS OFANY OTHER <br />STATE OR LCCAL L.4W REGULATlNG CONSTRUCTION OR THE PEnFORMANCE OF CONSTAJCTION. THAT 1 AM AUTHOFIZED BY THE <br />OW�lEF OF THIS PFOPEATY TO PERFORM THE WORK FOR WHICH APPL/CATION /S �YfADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 78.27 PCW AND 296200 WAC. <br />Ed�as-cr�� <br />Signature <br />�-,�-z a/ <br />Date <br />FEE <br />