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4a-7T <br />259-8810 <br />APPLICA,1ON FOR ELECTRICAL ?ERMIT <br />ss <br />CITY OF EVERETT <br />BUILDING DIVISION <br />C 3200 CEDAR STREET <br />EVERETT, WA 98201 <br />enantMail dress <br />ty tatc p one <br />55 <br />Contract Price of or <br />1 r"I .' <br />t r r'1 T/ q yq %Sar 7 ��•1PS <br />State prhune tate License No. <br />3`/-971 `l <br />ii f'S /�C•ri '_L <br />roposed se o ui d ng <br />Lo i 6 3 <br />Discription of Work To Be Done: _ f-"'(°14 w L9 e:7,5, Id pti T AL <br />NOTE: WAC 296-46-140 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 CERTIFY 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 UOVERNING 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 BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND 1 COMPLY WITH THE STATE <br />CONTRACTORS LAW 18.27 RCW AND 296.200 WAG. <br />X " / -'z s- <br />� <br />Signature Date <br />FEE _�S•0C% <br />3 94d,3 <br />