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t <br /> APPLICAI �JN FOR ELECTRICAL �'ERMIT 5�� 3 �� ; <br /> CITY OF F.VCRETT <br /> f1UIlDING OIYISION <br /> �] � 32D0 CfDM STREET <br /> �i� EV[RETT� NA 98201 <br /> p �'� 259-8810 . <br /> a�v� <br /> M Z �� ./�,"�i/ - . . � � .'__ � ' - ' � i� '� <br /> y �rp.� �er MaiT Aadrese �ity ta[e p � hone <br /> �i H 7�tl <br /> � y� Tenani Mai�ddres: tty La[e �p one <br /> � 2 � <br /> 9�d � . r< F n': -a,_�,�' Ec r . .��� t i %� � ���i: , � � , r ''</c"� �'� , i / J�� [% ` <br /> 0y� H ectnca ontractor e� ress ty Cete p one tate cense o. j <br /> Fit�+1� �c �aF..'f.'1 /L. ,����,. i <br /> p. C1 ° ' � <br /> � , <br /> �> H� on�tract�rlce oT�rTi— roposed se o ui ng <br /> �t" y � <br /> yy -%S',, , , • i'> <-�:, . � .���,:, <br /> H ro�ect Edress <br /> g ��, <br /> � � -- , , , � <br /> y Distription of Mork To Oe Done: �``7'�7^� C ':� � .�/� /` I�Y� < < I <br /> O�n , � <br /> — - -- ' <br /> 1 <br /> --� � <br /> , . i <br /> i <br /> ; <br /> ��„ � - — f <br /> NO�E: WAC 296-46-140 REOUIRES THAT PLANS FOR EIECTRICAL WOFK AT EDUCATIONAL� INSTITltIONAL OR HEALiH LAflE FACILIT�ES j <br /> BE APPROVEJ BY THE STATE OF WASHINGTON. APPLICANiS MITN SUf,H JOBS MUST SHOW 7ME STATE APPROVED PLANS BEFORE A � <br /> CITY OF EVI:flETT PERMIT MILL �E ISSUED. � <br /> � . ... � <br /> � , NOTE: X'IRINC �N NOC�DWELLINGS IS REOUIRED TO BE IN CONDUIT, <br /> � , I I HEREBY CEi1TIFY THAT I HAVE READ AND EXAMINED THIS � <br /> APPLICATION hN0 KNOW THE SAME TO BE TRUE AND CORPECL ALL <br /> PROVISIONS C1F UWS PND ORDINANCES GOVERNING THIS TVPE OF <br /> WORK WILI Bc CUMPLE7ED WITH WHE�}1ER SPECIFIED NEREIN OF <br /> NOT. THE GR�INTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> ` "+ AUTHORITY 'IO VIOLATE OR CANCEL THE PROVISIONS OF ANV <br /> OTHER STATE OR LOCAL LA'N RF:GUUTING CONSTPUCTION OR THE <br />' PERFORMANCIi OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE � �!U� <br />� '. �' OWNER OF TN'S PFOPERTY TO PERFOFlM THE WORK FOR WHICH fEF S(.� _ <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS lAW 18.27 RCW AND 29fi.200 WAC. <br /> � <br /> �,�� X . - ��/ 7 '1� �. / . <br /> � " ir , y � � ' - � <br /> 1�_—__—_-- <br /> Signature Dace <br />