Laserfiche WebLink
a <br /> �-- �L.ECI rti�AL P�RIVIdT APrLICAT{Ohl � <br /> CITY OF EV�RET�' PERMIT �ERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 <br /> `77�� �� t� - C.� �vu^e�� r Ln7��I< ,� <br /> PROJECT ADDRESS <br /> C�-�-= Po �� I�'�7`� � �� �r'�'c� sr���roc�d <br /> Cil Slale2ip Phone <br /> Ov:ner Mai'Address y <br /> Cit State/Z�p Phone <br /> Ten nt Mail Address 1' c� <br /> / �'/ / F- F c '�� �� ,-c� t� `����? `�?�C,- /p� <br /> itGwT f t lt ci��C 7 �� ��c \�t S f State2p Phone <br /> Electrical ConVactor Ma�l ACdress �'�Y <br /> ���7� ��� _,_ <br /> Stat icense Number Cortract Price of Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description oi W ork to Be Done: ' � t� i� C S� �° �C�, <br /> NOTE: PLANS FOR ELECTRICAL WORK AT EDUC�,TIONAL, FACILITIES UTILIZI�IG STATE rUNDS P�UST BE <br /> APPROVED BY THE STATE OF WASHINGTON. APPLICANTS 4VITH SUCH JOB�� MUST �HOW THE STP.TE <br /> EDUCAT ONAL FACILITI��S AND ALL�HEALTHC ARE FACILIITI SI PLANS WSLLEBE REVAEWED BY THIS OFFICF_. HER <br /> NOTE: '�11RING IN NON•DWELLINGS IS RE�UIRED TO BE IN RAC�WAYS, MC OR AC CABLE. <br /> WITHIN ACCESSlBLE SPACES OR ALONG IACC SSIBLE ROUTES OF�TRA`EL SHALL BE MOUNTED A MINIMUM <br /> OF 15 INCHES A.BOVE THE FLOOR. WAC 51-20 SEC. 3106(c)2. <br /> [NVIRONMENTAL AND OTNER CONTROL RECEPTACLES AND OTHER OPERABLE EQUIPMENT `.NITHIN <br /> RANGESI OF WAC 5E 20 SECL S1 6(b)CE & FIR^D NOT L S6 THAN 36LINCHES ABOV�E THE PLOOR IN THE �?EACH <br /> 1 HEREBY CERTIFY THAT I HAVE FEAD AND EXAMINED THIS APPLICATlON ANO KNOW THE SAME TO dE TRUE AND CDRRECT. ALL <br /> PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLETED WHETHER SPECIFIED HERELV OR <br /> ,'JOT, TNE GRANTING OF A PERMI r DCES NOT PRESUAfE TO GIVE AUTHORITY TO VIOLATE Jfl CANCEL THE PROVI�1.7NS OF AfJY OT'r'F_R <br /> SL4TE GR LOCAL LAW AEGULATING CONSTP.UC710N OR 7NE PERFORM14ANCE OF CONSTRUCTION. THAT 1 AM.7UTHORIZED 6Y 7r�E <br /> OV✓NER OF 7HIS PROPEFTY ,TO PERFORM THE WOFK FOR WHICH APPLICATION IS IdADE AND I COMPLY WITH THE STA��E <br /> CONTRACTCRS LAW 78.27 Rfi �AND 296200 WAC. <br /> r - � —� <br /> ���j ) `.. � �i�� PEE �� �� � <br /> � <br /> i <br /> � � Da;e <br /> �-�i �ature� I <br /> DEBIT &CREDIT CARDS ARE NOT ACCE?TED L U r/G�"l ��j'� <br /> �� � <br />