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APPLIC�.TION FOR ELECTRICAL, PERItiIIT <br /> C(TY OE EVERETI' ^ <br /> BUIL.DfNG DMSION ��� <br /> 32G0 C�DAR STREET �� <br /> EVERETT, WA 98201 <br /> 259-$F310 <br /> �6 �a ���_�l� 1� <br /> er Mail Addras �� ���� � <br /> C�r/ State/ZiP Phone <br /> Tecan[ " Mai1 Address . C�� <br /> Y SlatelZip . Phooe <br /> ��'1���i���.��__��'%��s�Q-��� a2�,(�5� �'/�,��-�,��j <br /> tlectn�!'CoqYr�c�for Ma� Addras Qr� S tc/�:o pboo� � <br /> ✓ State License No. <br /> Contraet Pnc�f� P o;ed C:s� or 3uilding <br /> ��� /�� ��� <br /> °roje:t Address "' <br /> Descriotioo of 1Vork ta Be �Jooe: � <br /> �'.�'� ��O10' /� <br /> YOTc: WAC ?96-46-140 REOUIRE; TH,.�T PL.�1'S rOR cL�.iC,yi. V�OR:; .-1T EDUCATIONr1L, INSTII'UTIONAL OR <br /> i�.'.L.TH C,�RE FACII.ITIES BE APPROVED By ?� ST.-1ic Or �V.-15I�.L*lGTOIJ. ,1.PPLIC.-1N7'S WlTH SUCH JOBS i <br /> ;�tUS"I'SH01V TI-IE STA� APPROVED ?L.-WS BErORr C[TY OF EVE�T PERh1IT 1VII.L BE ISSUED. <br /> NOTE: ti`/IItIIJG IN NON-D14ELLINGS IS �Q[IIREp TO EE Cd �tETAL.LIC R-�CEW.4YS (MC .�YD AC, ARE CABLES. <br /> NOT R:10EIVAYS). <br /> I .."'rP.EBY C�RTIFY THAT I HAVE READ ��YD �}(p�,{IVED 7'-�?S :+�oL!C:\TICN ,�ND iGVOW Tf�"t SAIvIE TO BE TRU� <br /> ��ND CORREC['. ALL PP.OVISIONS OF L?.WS .WD OP.DL`1ANC�S GOv=_P.NING TH'S TYPE OF WORK WII.L BE <br /> COMPLETED WI'I'H WHEiHER SPECIFLD f-CP,Ei'! OR NOT. T^:c G�2.•�NI'I\'G OF A rERh1IT DOES NOT YRESUhiL � <br /> TO GIVE AUTHORITY TO ViOLnT'E OR C.WCEL THfi PROVISIONS OF ANY OTFIER STATE OR LOCAL LA�4' <br /> P.EGUL�1TRdG CONSTRUCTION OR THF_ PEc2FOR.�t.'v�lCG OF CONSTR'JC�']ON. TFiAT I ��t AUII-IORIZED BY TFL <br /> OWNER OF I�-IIc pROPERTY TO PE�.FOR,'�f 7'r� W'OR:; FpR 11'F?ICF-I ,�ppLIC,�TION IS hfADE AND I COA(PLY "rYI'I'f: <br /> TIL6 STATE CONTFtqC7ORS LAW IS.27 RCW AND 296.2C0 WAC. <br /> Y • G � � /— 9� , Fee��- <br /> Sigriature '—'T— —� <br /> Date <br /> � u��5� <br /> �i<_nvu � <br />