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yc�H <br />�try-7� <br />�J y <br />�HfHi� <br />H�H <br />�H� <br />oxo <br />'i1 H � <br />CA H <br />z <br />Oyd�y <br />H/�L'��JO <br />y� V C] <br />9H� <br />i <br />Hy <br />g� <br />�d� <br />� � y <br />zy� <br />HOfn <br />I� <br />'w�r � <br />I •� ' <br />i <br />ih <br />\� � <br />CITY �F EVERETT <br />BUILDING DIVISION <br />3200 CEDAR STREET <br />EVERETI', WA 98201 <br />%'C��I. <br />O�wer <br />Teoant <br />�Sc�ND �'� <br />Electrical Contractor <br />APPLICATION FOR �LECTRICAL P�RIVIIT <br />C T �� C-� 13 <br />Mail .1�dress <br />� Mail Address - <br />c:r2�� 13sy T <br />hf�il Address <br />'(�I rn� E d- n� ��- 2 � R� <br />Contracf Price of Work <br />City <br />City <br />i�vcP�i <br />State/Zip � <br />Slate/Zip <br />�; a�S <br />reoo� <br />Phooe <br />��/�� P2,�i 3-c t7� <br />��s L�t�✓c �nir��a�r�s v✓R��aa� .�isuN:-�z��;o <br />Cit Sfate/Zip Phooe StateL�censeNo. <br />Y <br />nE�s,o� N��� — <br />Proposed Use of Building <br />SAm, c: �}-s r� wti� ,� — <br />Project Address <br />� �c � �i�ifi �: N <br />Description of Work to Be Doue: <br />r'_/Ir1o0� <br />,f� �/ - ���� c ✓ is <br />r"!�' �02,�t d-(3 <br />NOT'S: WAC 296-46-140 REQUI?ES THAT PLANS FOR ELECPRICAI- WORK AT EDUCATIONAL, INSTITU'ITONAL OR <br />_. <br />HEALTH CARE FACII.ITIES BE APPPOVF.D BY THE STATE OF WASHINGTON. APPLICANTS WiTH SUCTi JOBS <br />MUST SHOW Tf� �TATE APPROVED Yt•�`1S BEFOF.E CffY OF EVERET PERNiTT V�II-L BE ISSUED. <br />NOTE: WIItING IN tlON-DWELLIIv'GS 1S RLQUIRED'f0 BE IN METALLIC RACEWAYS (MC AND AC, ARE CABLES, <br />NOT RACEWAYS). <br />I HFREBY CERTIFY TTIAT I HAVE READ AND EXAMINED THIS APPLICA'ITON AND KNOW THE SAME TO BE TRUE <br />AND CORRECT. AI-L PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE <br />COMPLETED W1TH WI�i'HER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMTT DOES NOT PRESU1vfE <br />REGULATING CONST UCTION ORTTHE PERF�CkMANCE OPOCON TRUCTIOAjN.�THATT I AM ATU'ITiORIZED BYLTHE <br />OWNER OF THIS PROPERTY TO PERFOR.i THE WORK FOR WIIICH APPLICATION IS 2v1ADE hND I CGhiPLY WITH <br />THE STATE CONTFtACTORS LAW 18.27 RCW AN� z96.200 WAC. <br />� <br />� ' � <br />Datc <br />Fee % T G�' <br />daopp (!IS/93) <br />