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APPLICATION FOR ELECTRICAL PERMIT <br /> CITY OF EVERETT <br /> BUILDING DIVISION <br /> [3'F/tETr 7200 CIDAR STREET <br /> // EVERETT, WA 98201 <br /> 259-8610 <br /> Countrywood Haines 14410 Bel Red Road 1200, Bellevue, WA 98007 206-644-2323 <br /> air Mail Address LILY State/Zip Phone <br /> N/A <br /> eonT-- Hall Address City State/zip Phone <br /> fl�-guewl Electric tb., Inc. P.O. Box 1126 Woodinville, WR 98072 486-8934 F'ERGl1BC16OPK <br /> TecErice n nc air F1,11 Address city a s p Phone State License No. <br /> $125.00 Terporary Power Pole (Res) <br /> ontract r ce of WorkIupuse se o n9 <br /> 2612 57th St SW Lot 35 <br /> reject reu <br /> lecriptlon of Mork To Be Done, 9YWIoorary pQmr_DOlc <br /> NOTEI WAC 296-46.140 REQUIRES THAT PLANS FOM ELECTRICAL WORK AT EDUCATIONAL INSTITUTIONAL OR HEALTH CARE FACILITIES <br /> BE APPROVED BY THE STATE OF WASHINGTON. APPLICANTS WITH SUCH JOGS HUT SHOW THE STATE APPROVED PLAITS BEFORE A <br /> CITY OF EVERETT PERMIT WILL BC ISSUED. '- <br /> NOTE: MIRING IN NON-DWELLINGS 15 REWIRED TO BE IN CONDUIT. <br /> I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br /> PROV13IONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF - <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> NOT.THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT 1 AM AUTHORIZED By THE <br /> OWNER OF THIS PPOPERTY TO PERFORM IHE WORK FOR WHICH FEE f25 OG <br /> APPLICATION IS MADE AND 1 COMPLY WITH THE STATE <br /> CONTRACTORS LAW 18.27 RCW AND 298.200 WAC. <br /> X UU'J('A.WI <br /> Signature Date <br /> 3q��� <br />