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C1TY OF EVERET'I' <br />BUII.DINa DMSION <br />3200 CEDAR STREET <br />EVEREi'P, WA 98201 <br />Owner <br />Tm�nt <br />�D's E�, E <br />Hlectrieal Contnetor <br />Contnct Price of Work <br />Project <br />r� <br />r� <br />APPLICATION FOR EI,ECTRICAL PERMIT <br />C-C't'l��l ���1� � ?G�• �� �G <br />Mail Address <br />M�il Addroes . . <br />�o�, i3. <br />M�il Addrese <br />L, o <br />City <br />City <br />� <br />City State/Zip <br />`Ir � ��s <br />S�WZip <br />State/Zip <br />�n 7�/ — <br />Phone <br />Propoaed Use of Building <br />i� Cc+y� <br />�� <br />� <br />: g <br />�, , "> � 7���� <br />Deacriptioc of Work to Be Done: 5 ETT G-1° � � 1') <br />�- ��i � <br />Phone <br />Phone <br />State Licenae No. . <br />NOTE: WpC 296-46-140 RfiQUTAEg'ITiqT PLANS FOR ELECfItICpI, WpRi( AT EDUCATIONAL, INSTfI'f)'ITONAL OR <br />ii6AJ.TH CARB FACII.TI'IES Bfi APPROVED BY TH& STAT& OF WASHINGTON. APPZdCpN7'S WI'('g SUCH JOHS <br />MUST SHOW'I7� STATH APPROVED PLANS B&FORE CITY OF EVERE'f pEP,MiT WII;L BH ISSUfiD. <br />N9TB: WIItINp IN NON-DWELLWpS IS RF.QU(RfiD TO Bfi IN METALLiC RACbWAYS (MC AND AC, ARS CpgLEg, <br />NOT RACEWAYS). <br />I Fi&RfiBY CERI'IFY THAT I HAV& READ /Wp EXAMINED THIS APPLiCATTON AND I(NOW THfi SAME TO BIi TRUE <br />AND CORREC(', qLI, pROVISIONS OF LAWS AND ORDINANCES GOVEIWITJp T'HIg 1'ypfi OF WORK W,�L,[, BE <br />COMPI,E'['bp WP�'H W�-��R SPfiCIF'Ifip HEREIN OR NOT. TNE GRANTINp OF A PERMIT DOFS NOT PRESUM& <br />TO GNH AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHFR STAT& OR LOCAL LAW <br />RE411LA7TNa CONSTRUCTION OR THfi PERFORMANCE OF CONSTRUCI70N. THAT I AM AU7'HORIZgD BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THG WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WlTH <br />7iiE STAT& CONTRpCI'OAS LAW 1g,Z7 RCW AND 296.200 WAC. <br />�X <br />��-1 %It� ��%� � C �1�' l � <br />Signeture Dal�— <br />�//O n <br />�� <br />�i«.rv �isro» <br />