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�APPLICATIGA FOR ELECTRICAL F -RMIT <br /> , 1L <br /> crcc� � <br /> .an or - <br /> eYeYeff AUG 10 1993 <br /> BUILDING DEPAIITMENF <br /> 2598010 CITY OF EVE•RETT <br /> PublIC Works Dept. <br /> Ab QLAFSa,-J y3/ 6e7Y S7 5e Cu6,tt ;,,- 1,/, jVw3 353- YS76 <br /> nner --IieTni�ress - ty p hone <br /> enT ant .-IT resl�Td s-qty Zip —Prone o0-9 727y7ZL <br /> ss ,ECEc7Lcc 117 6-0 //lam` _�E t-2crZ � ✓e GT/A /Ae'Vy _ .55e' %B <br /> ectr ca Contractor fall-Ad rens ZTty ZIP tone tcense A <br /> Contract Price of or roposet se oT-IIutlndT g <br /> - Y3 A 1 607* .57- SE- Eue.terr wg 98to3 <br /> o er. <br /> r ' dress <br /> t script on of 'Work To Be one: <br /> /DoAM/� �Zc/O✓ S6C✓tie' C/YgyGc' <br /> NOTE: WAC 296-16-I'40 REQUIRES THAT PLANS FOR ELECTRICAL WORK AT F.DIIFATIONAL, HIFTITUTIONAL OR HEALTH CARE FACILITIES <br /> BE APPRO%ED BY THE STATE OF WASHINGTON. APPLICANTS WITH SUCH JOBS MUST SHOW THE STATE APPROVED PLAITS BEFORE A <br /> CITY OF EtERETT PERMIT WILL BE ISSUED. <br /> NOTE: WIRING NI NON-OWELLING5 15 REQUIRED TO BE IN HF.TAL RACEWAYS. <br /> I HEREBY CERTIFY THAT I HAV EXAMINED THIS <br /> APPLICATION AND OE <br /> T E AND CORRECT.ALL <br /> PROVISIONS OF LAIN ERNING THIS TYPE OF <br /> WORN WILL BE COHE R SPF.CINIED HEREIN OR <br /> NOT. THE GRANTIMIT S NOT PRESUME TO GIVE <br /> AUTI,ORITY TO VA L THE PROVISIONS OF ANY <br /> OTHER STATE On ULATING CONSTRUCTION OR THE <br /> PERFORMANCE OION. THAT I AM AUTHORIZED BY THE ZC�p <br /> OWNER OF THIS RFOnM THE WORK FOR WHICHAPPLICATION ISD I COMPLY WITH THE STATE <br /> CONTRACTORS LAAND 296.200 WAC. <br /> ADMINISTPAMR1011PUMSOR <br /> X TOii FcRMITTING POR°USES ONLY <br /> �F- Z7- 93 <br /> Signature Date <br />