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APPLICATION FOR ELECTRICAL PERMIT <br /> CITY OF EVERETT <br /> BUILDING DMSION <br /> 3200 CEDAR STREET <br /> EVERETT,WA 98201 259-88f0 <br /> UP � �^� r,v� �&t�s' N�' lt6 �i f��KLANA�u�� 9bv3'� 6�fYZb99 <br /> Owner Mail Address City State/Zip Phone <br /> 1�,�,-�s A-�� lr-���� nz,r ��o� �� �ri�- w� 9 �00�— <br /> Tenant Mail Address . Ciry S:aceiz,ip Phone <br /> s-v�—�i�9 PoL�AE� <br /> �o/l�ar'� �%Ec-�2�c j�/,6 .S��vNys�ic�. %/. ,Sr'A G�A 9 ?1�03 d ° ?�K � <br /> Electrical Contractor Mail Address City State/Zip Phone State License No. <br /> � I� LOo °� �lU�j '�"Ac.� -Itc�� <br /> Contract Price of Work Proposed LTse of Building <br /> I O I 1 0 ve r 4 /'Ec=/� W� � <br /> Projut Address <br /> Description of Work to Be Done: 1�0 0 �cJ �C'�G � � 0 � �� r � � ��� <br /> . <br /> �OL. O.�'/c��jv� l A-nl n! ti q �o wC N ,Q�p C irC, I vL <br /> �d,, /2e A.P �-,�-.. ��s (� <br /> NOTE:WAC 296-46-140 REQUIRES THAT PLANS �OR ELECTRICAL WORK AT EDUCATIONAL, INSTITUTIONAL OR <br /> HEALTI-I CARE FACII.ITIES B:,' APPROVED BY ',"HE STATE OF WASHINGTON. APPLICANTS WITH SUCH JOBS <br /> MUST SHOW THE STATE APPROVED PLANS BEFURE CITI' OF EVERET PER1vI1T WILL BE ISSUED. <br /> NOTE:V,'IRING IN NON-DWELLINGS IS REQUIRED TO BE IN METALLIC RACEWAYS (MC AND AC, ARE CABLES, <br /> N�T RACEWAYS). <br /> I HEREBY CERITFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE <br /> AND CORREGT. ALL PROVISIONS OF LAWS AIvD ORDiNANCES GOVERNING THIS TYPE OF WORK WILL BE <br /> COMPLETED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRAN'PING OF A PER',SIT DOES NOT PRESUME <br /> TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW <br /> REGULATING CONSTRUCTION OR THE PERFORMAI�CE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br /> OWAIER OF THIS PROPER'I Y TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WI'I'H <br /> THE STA'I'E CONTRACI'ORS LAW 18.27 RCW AND 296.'L00 WAC. <br /> X /J-�� � 1"� � �l� 3�q3 Fe� �c� <br /> Signature Date <br /> �//�� � elccnPP(3/5/9J) <br />