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APPLICATION FOR rL�C7'RICAI, PI'sItMIT <br /> CITY OF EVERETT <br /> BUiLDING DIVISION <br /> 3200 CEDAR STREET <br /> EVERETT, WA 98201 <br /> 259-88f0 <br /> y i � <br /> �`�/55<'_ � � Ul„S� � ��1 C � 71� � �1� �� '-�T v(�l F;.���- � � � 1 �.+'a l.'r��? 7u_' Ll�l � ) <br /> �_ <br /> O�mer Meil Addrus City State/Zip Phone <br /> _ �`l��l <br /> Teueht Meil Address Ciry State/Zip Phooe <br /> � >� � <br /> Ne4) �J�.1� t �e �'�� i� f��7 I�,gl�l����� /1 ,�� l,�,�1� <<�A yu '-�'I �`*(,� <br /> Electrical Conlrector Mail Address Cily SletelZip Phone Stnle License No. <br /> ���(�,��- ��ee,i �o �n( �' <br /> Contract Price o(Work Proposed Use of Building <br /> C�1 � IcB �' F�_ SC F.«���, ��� 4S' ��� <br /> Project Address <br /> Description of Work to Be Done: �'�J��/e I/F; �- ) O1 G�_ _ <br /> NOTE:WAC 296-46-140 REQUIRES THAT PLANS FOR ELECTRICAL WORK AT EDUCATiONAL, INSTITUTIONAL OR <br /> HEALTH CARE FAC[LiTIES DE APPROVED BY THE STATE OF WASHINGTON. APPLICANTS WITH SUCH JODS <br /> MUST SBOW THE STATE APPROVED PLANS BEfORE C(TY OF CVERE'C PERMIT WILL BE ISSUED. <br /> NOTG:WIRING IN NON-DWELLiNGS IS REQUIRED TO BE IN METALLIC RACEWAYS ;MC AND AC, ARE CABLES, <br /> NOT RACEWAYS). <br /> 1 HFREBY CERTIFY THAT 1 HAVE READ ANU EXAMINED THIS APPLiCAT10N AND KNOW THE SAME TO BE TRU[ <br /> AND CORRECT. ALL PROVISIOtJS OF LAWS AND ORDINANCES GOVERNING 'T'H1S TYPE OF WORK WILL AL• <br /> COA4PLETED WITFl WHETHER SPECIFIED HGREiN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME <br /> TO GIvE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STA7'E OR LOCAL LAW <br /> REGULATING CONSTRUCTIO�` OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED HY THE <br /> OWNER UF THIS PROPLRTY TO PERFORM THE WORK FOR WHiCH APPLICATION IS MADE AND I COMPLY WITH <br /> THE �TATE CONTRACTO�jS LA� 18.27 RC�AND 296.200 WAC. <br /> ��l`,5� � � �'.� 5-l�`"`-"' �"� � -� v'�- <br /> � 1 � <br /> k � �.� ��i <br /> � �-���'' '�� � � , � ��'!' `� Fee— — <br /> Signature � Dele <br /> �� � � � � ..1�L �" ,� � �`1[ � �1"1� <br /> � �i«s <br /> , �_ . rr O�y�q��. <br />