2620 58TH ST SW 2016-01-01 MF Import

APPLICATION FOR ELECTRICAL PERMIT CITY OF EVERETT BUILDING DIVISION 3200 CEDAR STREET EVERETT, WA 98201 259-8810 Countrywcxd Nares 14410 Bel Red Road, Suite 200, Bellevue, WA 98007 206-644-2323 nem a: Address City tate one N/A Tenant Mail Address City tate .p Phone Ferguson Electric Co., Inc. P.O. Box 1126, Woodinville, WA 98072 486-8934 FERGUEC160PK �lectrical Contractor Mail AddrFs-s City State/Zip Phone State cense No. $12500 rare Power Pole .ontract Pace o or Proposedse of buil ng 2620 58th St SW Lot 17 'ro ect Address Jiscription of Work To Be Done: Temporary power pole i i NOTE: WAC 296-46-140 REQUIRES THAT PLANS FOR ELECTRICAL WORK AT EDUCATIONAL, INSTITUTIONAL OR HEALTH CARE FACILITIES BE APPROVED BY THE STATE OF WASHINGTON. APPLICANTS WITH SUCH JOBS MUST SHOW THE STATE APPROVED PLANS BEFORE A CITY OF EVERETT PERMIT WILL BE ISSUED. NOTE: hIRING IN NON-UWELLINGS IS REQUIRED TO BE IN CONDUIT. I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL PROVISIONS OF IAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL dE COMPLETED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE.PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH FEE $25.00 APPLICATION IS MADE AND I COMPLY WiTH THE STATE CONTRACTORS LAW 18.27JRCW AND 296.200 WAC. Signature Date / G � 1� U)