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ELE <br />r�ICAL PERMIT APrLIC�4TION <br />CITY OF EVEf�ETT PERMIT SERVICES <br />3200 CEDP.R STREET, EVERETT, WA 98201 <br />425-257-881 C - FAX 425-257-8857 <br />9 7�� = / �'�� �9 v� !�f/ <br />PROJECT ADDRESS <br />G.�,�€��x�y' i� oM,�s <br />Owner <br />Tenant <br />Mail Address <br />Maii Address <br />City <br />City <br />State/Zip <br />StatefLip <br />Phonu <br />Phone <br />/�r � � �,c,� i v r c�� �i � — <br />Eleclrical ContraClor Mail Address City Stale�Zip Phono <br />/LI�L�/�✓.�Go 03.0 J— — <br />State License Number <br />��� <br />Proposed Use of Building <br />Description of Work lo Be Done: W����- �'`�� `Sf� <br />Contract Price of W ork <br />Contact Person (Plan Review) <br />� o c1 /3-�P <br />NOTE: PLANS FOR ELEt;TRICAL WORK AT EDUCATIONAL, FACILITIES UTILIZING STATE FUNDS MUST BE <br />APPROVFD BY THE STATE OF WASHINGTON. APPLICANTS WITH SUCH JOBS MUST SHOW THE STATE <br />EDUCATIONAL FACILBITIE�S AND ALL OHGALTH CA E FACILITI SI PLANS WSLL BE REV EWED BY THIS OFFI OTHER <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO BE IN RACEWAYS, MC OR AC CABLE. <br />HANDICAPPED ACCESSIBILITY: ELECTRICAL APJD COMMUNICATIONS SYSTEM RECEPTACLES ON WALLS <br />WITHIN ACCESSIB�E 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 />RANGES OF WAC 5E 20 S CLON 6(b 4CE & FI ANDR OTTL S8 THAN 36LINCHES ABOV�EUTHE �LOO(� IN THE REACH <br />1 HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINEC ThIIS APPLICAT/ON AND KNOW THE SAME TO BE TRUE RND CORFECL ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVEf7NINr THIS TYPE OF WORK WILL BE COAIPLETED WHETHER SPECIFIED HEREIN OR <br />NOT, THE GRANTING OF A PERMIT DOES MOT PRESUME TO GIVE AUTNORITY TO VIOLATE OR CANCEL THE PP.OVISIONS OFANY OTHER <br />STATE OR LOCAL LAN✓ HEGULATING CONSTRUCTION OR THE PERFOFMANCE OF CONSTRUCTION. THAT I AM AUTHOAIZED BY THE <br />ObVNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATc <br />CONTRACTORS LAW iH.27 RCW AND 296200 WAC. - <br />DEBIT & CRE�IT CARDS ARE NOT ACCEPTED �P3 C%—G3 G <br />FEE}�` 0 0 <br />55 <br />