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,. �x,_ <br /> APPLICATION FOR �LECTRICAL P�RMIT <br /> CITY OF EVERETT <br /> BUILDING DIVISION <br /> 3200 CEDAR STREET <br /> EVERETT,WA 98201 259-8810 <br /> Hx O H <br /> [�f [��l y � ���. <br /> � � � � r �� � � x�� � r ,. ��� d.uf_ �C� � i.�f'�'+-ri"l,t��t �'�_'�> .�s'_ s'ie,. <br /> � x � (�� � �����V��-c�� ;,.,�� - � <br /> � y y Owner Mail Address City State/Zip Phone <br /> y� H <br />' �! f] <br />' H 70 <br /> "�� Ix—i '� Tenanl . . . . Mail Address . City State/Zip � Phoue <br /> VJ M <br /> yx <br /> �' y d ���'hl1%i�- <br /> H <br /> Electrical Contraclor Mail Address City State/Zip Phone Slate License No. <br /> � � g <br /> �� � ��?q- <br /> y H � Contract Price of�Vork Proposed Use af Building <br /> t" y "� <br /> g " y y?��� s�' ,4 r.�E ���'�,�- <br /> � <br /> n d y Project Address � <br /> �� � Description of Work to Be Done: ��� ��-! �`7 �J� ��1��� ��l�Ll�C �G�/� _�,fi��� <br /> ON <br /> � <br /> i <br /> � �� <br /> �I NOTE:WAC 296-06-140 REQUIRES THAT PLANS FOR ELECTRICAL WORK AT EDUCATIONAL, INSTITUTIONAL OR <br /> HEALTH CARE FACILTTIES BE APPROVED 5Y THE STATE OF WASHINGTON. APPLICANTS WTTH SUCH JOBS <br /> MUST SHOW THE STATE APPROVED PLANS BEFORE CITY OF EVERET PLRMIT WILL BE ISSUED. <br /> i �� NOTE:WIRING IN NON-DWELLINGS IS REQUIRED TO BE IN METALLIC RACEWAYS (MC AND AC, ARE CABLES, <br /> , NOT RACEWAYS). <br /> I HEREBY CERTIFY'fHAT I IiAVE READ AND EXAMINED THIS APPLICATTON AND KNOW THE SAME TO BE TRUE <br />�, :, =1 � AND CORRECT. ALL PROV]SIONS OF LAWS AND ORDINANCES GOVERNING TFIIS TYPE OF WORK W1LL BE <br />, i COMPLG'CED WITH WHE•THER SPECIFIED HERLIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME <br /> TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW <br /> REGULATING CONSTRUCTION OR THE PL•RFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br /> =,�� OWNLR OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATiON IS 1�4ADE AND I COMPLY WITH <br />� THE STATE CONTRACTORS LAW 18.27 RCW AND 296.2001VAC. <br /> 1 <br /> 1 � � i <br /> ��. X � �, i <br /> % <br /> . � <br /> � cb��-�/��'�i ����,�!✓- .- �� r•� � `' <br /> --- Sienamro "��� � D�te <br /> , /C�'J�1�/ <br /> �' <br /> dccnpp(3/5/9J) <br />