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ELEC � RICAL PERMiT AF 'LICATION <br />�ITY OF EVERETT PERMIT SERVECES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 <br />°i(�o7 � g-�ti, ��� ��J ��f I <br />PROJECT ADDRESS <br />G <br />Owner A1ail Address Ciry StatelZip Phone <br />Tenanl Mail Address City <br />��� M�Lc c�v-� c Z�il l� F'�N� <br />Electrical Contrector Mail Address C��y <br />�C6t� F) CC�'b�� J 1 <br />State License Num6er <br />i)__. �� <br />Proposed Use of Building <br />State2ip <br />Slate2ip <br />ftSoi,�' <br />Contract Price of Work <br />Phono <br />ZSZ"yyci <br />Phone <br />Contact Person (Plan Review) <br />Description of Work ro Be Done: ( �(7 �i' wL�� �t^� � u U-E W r� 5� ewr�. <br />NOTE: PLP.NS FOR ELECTRICAL WORK AT EDUCATIONAL, FACILITIES UTILIZING STATE FUNDS MUST BE <br />APPROVED BY THE STATE OF WASHINGTON. APPLICANTS WITH SUCH JOBS MUST SHO`N THE STATE <br />EDUCAT ONAL FACILBITIEB AND ALL H�EALTH C.4RE FACILIITI SI PLANS WSLLE E R VAEWED BY THIS OFFI OTHER <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO BE IN RACEWAYS, MC OR AC CABLE. <br />HANDICAFPED ACCESSIBILITY: ELECTRICAL AND COMMUNICATIONS SYSTEM RECEPTACLES ON WALLS <br />OF 16 NCHESSABOVE THE FLOOR.AWAC 51A-20 SEC. 5106(�2 TES OF TRAVEL SHALL BE MOUNTED A MINIMUM <br />ENVIRONMENTAL AND OTHER CONTROL RECEPTACLES AND OTHER OPEf�,ABLE EQUfP(�1ENT WITHIN <br />RANGESI OF WAC SE 20 SEC.�3N 6(b 4CE & FI ANDR OUT L S8 THAN 36LINCHES ABOV�EUTHE �LOOR.�IJ THE REACH <br />i HEREBY GEFTIFY THAT 1 HAVE REAO AND EXAM�NED THIS APPLICATION AN� KNOW THE SAME TO BE TRUE AND COFRECT. ALL <br />PFiOVISIONS OF LAWS AND OR�INANGES GOVERNING TNIS TYPE OF WORK 4VILL BE COMPLETED WHETHER SPECIFIED HEFEIN OF <br />NOT, THE GRANTIIJG OF A PERMIT DOES NOT PRESUME TO GNE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER <br />Ol^lNER OF�THAS PROPERTYATO PER�F RMUTHrE WORKT FOREWH�CH APFLI� TION �SRMAD� AND ACOMPLY�I WITHIZ7HE STATE <br />CONTFAGTORS LAW 78.27 RCW AND 296.200 WAC. <br />� <br />Signa�ure <br />DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />� FEE <br />Date <br />� �3� 9-cls3 <br />� <br />