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ELECT r�ICAL PERIVIIT APrLIC,�ATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 <br /> �, , � _. <br /> � j ,<� I ( _ � ��., �., � , z�� �i ��,'1 ? _� <br /> PROJECT ADDRESS 'I <br /> C li_� I �-it C�. k �F. 1�1 ` � -�,�c ( �,,., `% �'iC- ;�i`: " 16( .- I <br /> Owner Pdail Address City State2ip Phcne <br /> Tenant Mail Address City Stale2ip Phone <br /> (-� . •� � � ,i' i � � � � � F�,(1 �(i �` ti � �� `\t..-e. l "�� l�'�=�='-�l�i >;C - %C '�Y ' <br /> Electrical Cont�aclo� Mail Address Ci�y State2ip Phone <br /> 7�� � j� Y)I �� <br /> Slale License Number Con�ract Price or Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> , � <br /> i / / <br /> Description of Wark io Be Done: � �� ��, �' t- ! { ��i i�>� <br /> NOTE: PLANS �OR 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 /> APPROVED PLANS BEFORE CITY OF EVERETT PERMIT WILL BE ISSUED. WAC 296•46-140. ALL OTHER <br /> EDUCATIONAL FACILITIES AND ALL HEALTH CARE FACILITIES PLANS W ILL BE REVIEW ED BY THIS OFFICE. <br /> NOTE: WIRING IN NON-DWELLINGS IS RFQUIRED TO BE IN RACEWAYS, MC OR AC CHBLE. <br /> HANDICAPPED ACCESSIBILITY: ELECTRICAL AND COMMUNICATIONS SYSTEM RECEPTACLES ON WALLS <br /> WITHIN ACCESSIBLE SPACES OR ALONG ACCESSIBLE ROUTES OF TRAVEL 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 /> ACCESSIBLE SPACES OR ALONG ACCESSIBLE ROUTES OF TRAVEL SHALL BE MOUNTED WITHIN THE REACH <br /> RANGES OF WAC 51-20 SEC. 3106(b)4 E & F AND NOT LESS THAN 36 INCHES ABOVE THE FLOOR. <br /> I HEFE3Y CER7IFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TAUE AND CORRECL ALL <br /> PFOVISIONS OF LAWS AND ORDINAA'CES GOVERNING THIS TYPE OF WORK WILL BE COMPLETED WHETHER SPEClFIED HEREIN OA <br /> NOT, THE GRAN7ING OF A PERMIT DOES NOT PRESUME TO GlVE AUTHORITY TO VIOLATE OR CANCEL THE PFOVISIONS OFANY OTHER <br /> S(ATE OR LOCAL LAV✓REGULAT/NG CONSTRUCTION OR 7'HE PEFFOFMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PFOPERTY TO PERFORAI THE WORK FOR WHICH APPLICATION IS M11ADE AND 1 COh1PLY WITH THE STATE <br /> CONTRACTORS L7W 1827 FCW AND 296.200 WAC. <br /> . i � � <br /> �' <br /> i ✓- '-\ .i / � <br /> ��;, � _'`"-�.- `- ',l '� l��l Fee r��j �'� <br /> � <br /> Signature Date <br /> '1 l ? <br /> DEBIT&CREDIT CARDS ARE NOT ACCEPTED ��� �` v <br />