Laserfiche WebLink
� <br />ELEC TRICAL PERMIT p�''PLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CFQAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 <br />G I � - ,��-� y �. S,� �. ,�a 6 �ti'r� �u� <br />PROJECT ADDRESS <br />•R-i/�.._,.,,,.. 9�-��. �l��Au� S,z�%��� 9�1�1� <br />OWnef <br />�? <br />Tenant <br />Mail Address <br />��0� �/�'— <br />Muil AOtlrass <br />CoNraclor Meil Aadress <br />,�= Y�� N�5 /�.( Z� P <br />State License Number <br />�' %/ d..�� 1�� t+.il � <br />Proposed se ol Building <br />Description ol Work to tie Done: <br />City <br />s S�� c <br />City <br />tCve <br />Ciry <br />S�le2ip <br />Slete2ip <br />Slete2lp <br />Contract Pr�:�e ol Work <br />Contact Person (Plan Review) <br />r� � <br />Phone <br />Phone <br />-�.t <br />Phone <br />NOTE: P ELECTRICAL VJORK AT EDUCATIONAL, FACILITIES UTILIZING STATE FUNDS MUST BE <br />APPFOVED BY THE STATE OF WASHINGTON. APPLICANTS W�TH SUCH JOBS MUST SHOW THE STATE <br />EDUCATIONA FACIUT E3 AND ALL �EALTH CARE FACILITI SIPLANS WSLLE E REV EWED BY THIS OFFI OTHER <br />NOTE: WIRING IN NON•DWE�LINGS IS REdUIRED TO BE IPJ FACEWAYS, MC OR AC CABLE. <br />HANDICAPPED ACCESSIOILITY: ELECTR�CAL AND COMMUNICATIONS SYSTEM RECEPTACLES ON WALLS <br />OFT SI NCHES ABO E THE FLOOR.AWAC S1A-20 SEC 81106(�2 TES OF TRAVEL SHALL BE MOUNTED A MINIMUM <br />ENVIRONI�IENTAL AND OTHER CONTROL RECEPTACLES AND OTHER OPERABLE EOUIPMENT WITHIN <br />FANGESIOF WAC 5E 20 SEC..�3N06(b)4CE & FI AND NOT LESS THAN 36LINCHES ABO E THE �LOOR IN THE REACH <br />1 HEREBY CER7IFY THAT I HAVE FEAD AND EXAM1IINED THIS APPUCAT/UN AND KNOW TNE SAME TO BE TRUE AND CORRECL All <br />PROVISIONS OF LA1V5 AND OFDINANCES GOVEFNING 1M15 7YPE OF WOFH WILL 6E COM^LETED WHETMER SPECIFIED NEREIN OR <br />NO7 THE GRAN7ING OF A PERMIT DOES NOT PRESUAIE TU GIVE AUTHORITY TO VIOLA rE OF CANCEL THE PFOVISIONS OF ANYOTHEF <br />S'A7E OR LOCAL LAW REGULr171NG CONSTFUCTION OR THE PERFORMANCE OF CONSTFUCTION. THAT 1 AM AUTHORIZED BY THE <br />OWNER OF THIS PFOPEATY TO PEHFORM THE WOFK FOR WHICH APPL/CATION IS MADE AND 1 COMPLY WITH THE STATE <br />CONTRACTORSLAW 18.<^.'FCWAND.'96.200WAC. <br />� � � <br />� � � <br />Signa�� Dele <br />CAP�REV &2001) <br />FEE 3s�° <br />E�a�i-�3 <br />