Laserfiche WebLink
APPLICAI ION FOR ELECTRICAL PERMIT <br /> CITY OF EVERETY <br /> BUILDING DIVISION <br /> 3200 CEDAR STRPET <br /> EVERETT, WA 98201 <br /> 259-8810 <br /> 7/O J /C trr . r9/z / .ff.7- s-5r % - <br /> ner <br /> 647 Xddre3s tytate ST p phone <br /> �CArI ��Yk �IrnU cLATCt)1� �yiL �QI� ��l() �f - LA)A ��'1J7 "?H <br /> Tenant —F{a1 ddress ty tate tiD 'lone <br /> X174 i1Y� `iSfs- <br /> N�cRloraAl CEfV1�Fz �IE� IIUn- e1v� At_e � 1 iA' Y � n� ) <br /> U ectr ca ontractor ai dress Ci'.y Mate p 2—�ta�e LICen a u. <br /> t h-0r>,� SIS-5r�15 <br /> ontract vrice or work Proposea use DTII—ui tling <br /> roJect ddress <br /> D15cription of Work To Be Done: <br /> NOTE: WAC 296-46-100 REQUIRES THAT PLANS FOR ELECTRICAL WORK AT EDUCATIONAL, INSTITUTIONAL OR HEALTH CARE FACILITIES <br /> BE APPROVED BY THE STATE OF WASHINGTON. APPLICANTS WITH SUCH JOBS MUST SHOW THE STATE APPROVED PLANS BEFORE A <br /> ,CITY OF EVERETT PERMIT WILL BE ISSUED. <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO BE IN CONDUIT. <br /> I HEREBY CER-IFY THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> PROVISIONS 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 I AM AUTHORIZED 8Y THE I <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH FEE <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 10.27 RCW AND 296.200 WAC. <br /> X \ <br /> r� aA� yuoG�n <br /> S i gghture Date <br />