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CITY OF EVERETT <br />BUILDING DMSION <br />3200 CEDAR STREET <br />EVERETT, WA 96201 <br />Owner <br />Ten�nt <br />APPLICATION FOR ELECTRICAL PERMIT <br />Mal Addrcss <br />Mail Address <br />�3��� <br />City <br />Ci�y <br />� • ../�.�'�'►s�/ C✓9 <br />Slate/Zip <br />S�ate/Zip <br />�� <br />Phone <br />Fhone <br />7"��,��cT,¢ic_ <br />Elxlrical Contractor Msil nddross Cily Stale/Zip Phooe Stete Liceose No. <br />� <br />Contract Price of Work <br />262� - l0 i Sf�t�S,�, <br />Project Addrese <br />Proposed Use of Building <br />Description of Work to Be Done: %/,�IJ✓,� /GY.��fie f'�/�� <br />NOT&: WAC 296-46-140 REQU[RES THAT PLANS FOR E[.ECIRICAL WORK AT EDUCATIONAL, INSITCUTIONAL OR <br />HAALTH CARE FACILITIES BE APPROVED BY THE STATE OF WASHINGTON. APPLICANTS W1TH SUCH JOBS <br />MUST SHOW TFffi STATE APPROVED PLANS BEFORE CITY OF EVERET PER2vf1T WILL BE ISSUED. <br />NOTE: WIRING IN NON-DWELLINGS IS REQUfRED TO BE IN METALLIC kACEWAYS (MC AND AC, ARE CABLES, <br />NOT RACEWAYS). <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINEll THIS APPLICATTON AND KNOW THE SAME TU HE TRUE <br />AND CORRECI'. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING 'fHIS TYPE OF WORK WILL BE <br />COMPLETED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRF.SUME <br />7'O GiVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF /,NY OTHER STA'fE OR LOCAI. LAW <br />REGULATTNG CONSTRUCI70N OR THE PERFORMANCE OF CONSTRUCi'1�)N. THAT 1 AM AUTHORIZED HY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLIChT10N IS MADE AND I COMPLY Wfi'H <br />'fHE STATE CONTRACTORS LAW 16.27 RCW AND 296.200 WAC. <br />X <br />Signature <br />Deie <br />A.� <br />Fee <br />a�o.rv J�sroi� <br />