Laserfiche WebLink
APPLICA� i0N FOR ELECTRICAL PERMIT <br /> t7 '~0 CITY OF EVERETT . <br /> b� y lIUILDINC DIVISION <br /> i0 71 � 3200 CmAR STREET <br /> C � y EIIERETT, IIA 98201 <br /> � N 259-8810 � <br /> a r' <br /> ro �" � ��A tYL�.no N 1 a (`70 L �3`r 1-N-,qy.,� w �ce✓ �N�t- `1tY03Sa �j b�S�3S- <br /> N �� ,y Owner Mail Address ity $tate Lip Phone <br /> � ;9 �j ¢�� d�—�— Mai Address (.ity tate �p hone �.-y� <br /> �c M � , 1 �-U�V-�`G i` <br /> F " 1—�-C�v.nw-�✓ �65�`1 I�I S%��Sv Saal, W�eq� Yo `j�CS � Sz � ��'193rv1 <br /> �"� � ectrical ontractor Mail ddress itZ-y 3tate �p hone�tate G cense�— <br /> N �� <br /> � �O N \�LS l '��� �� � <br /> � ontract Price� Proposed Use of Building <br /> O N <br /> s�a ��T� P� s��. �� <br /> ro�ect Address �� � <br /> Discription of Work To Be Done: �� �� ���� — , <br /> f <br /> � <br /> I <br /> I <br /> �c e''' <br /> 1 NOTE: WAC 296-46-140 REQUIRES THAT PLANS FOR ELECTRICAL WORK AT EDUCATIONAL, INSTITUTIONAL OR HEALTH CARE FACILITIES <br /> BE APPROVED BY THE STATE OF WASHINGTON. APPLICANTS WITH SUCH JOBS MUST SHOW THE STATE APPROVED PLANS BEFORE A <br /> '�� CITY OF EVERETT PERMIT WILL BE ISSUED. <br /> � ��' NOTE: WIRING IN NON-DWELLINGS IS REOUIRED TO BE IN CONDUIT. <br /> I, , <br /> ' 1 HEREBY CERTIFY THAT I HAVE READ AND� E%AMINED THIS <br /> � I �� APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECt ALL <br /> � PFiOVISIONS OF LAWS AND OR�INANCES 60VERNING THIS TYPE OF <br /> - I WORK WILL BE COMPLEfED WITH WHETHER 3PECIFIED HEREIN OF <br /> � _ NOT. THE GFANTING OF A PERMIT �OES NOT PRESUME TO GIVE <br /> � AUTHOFITY TO VIOLATE UR CANCEL THE PROVISIONS OF ANY <br /> '� f�I� OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE � � <br /> ' PERFOFMANCE OF CONSTRUCTION.THAT I AM AUTHORRED BY THE <br /> � OWNER OF THIS PROPERTY TO PERFORM THE WOflK FOR WHICH FEE <br /> APPLICATION �S MAOE AND I COMPLY WITH THE STATE <br /> il '_1�I CONTR T S LAW 18. 7 RCW AND 296.200 WAC. <br /> I X <br /> .- �'� 2`� � <br /> , 1��� <br /> � ' � Signature Date J � <br /> r <br /> 1 <br /> 1I <br /> . 1 <br /> � <br /> � <br />