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i <br /> APPLICAT�UN FOR ELECTRICAL NERMIT <br /> � CITY OF EVERE7T <br /> f1U1LI11NG DIVISION <br /> ��r((f]]� 3200 CEDAR STREf.T <br /> q [V[RCTT, MA ^A20' <br /> p � 259-8810 <br /> ("',. H <br /> H�� �� r,inirn.' Ic'C ��Il� --- — — <br /> y H �cr Ma�l AdJress �i[y tatc ip Phonc <br /> K n <br /> H 7d <br /> � N� enant a d ress / [y tate p one <br /> ' yy�� <br /> � �� �� '�' '� . c� � ,r.- �c" � 7 /���•�r;,�C�f"r%r ,Y.f ll��lY�l,��''�r � �i-G4�,�" -C� '����1 <br /> c[r c e o n t r a c t o r a � d�e sd s�— [y t a� p o ne—S[a t e c e n s e o. � <br /> �/� �g <br /> y�V � <br /> � �„�� ontrac� t�r c�o(TFor � ropose se o u ing � <br /> t" y <br /> ` �H ��3� �''�� ��v f�r� � , �l'e � ��� !1— � <br /> � ect adress <br /> C'] C y J <br /> ��� Dlscriptfon of Work To Be Done: ��(C� �����C.- - ��[' //11!' j�� /� � <br /> E <br /> 4 <br /> , <br /> , <br /> , <br /> ; <br /> ; <br /> ; <br /> �- - ! <br /> � ! NOTE: WAC 296-46-140 HEOUIRES THAT PLANS FOR ELECTRICAL NORK AT EDUCATIONAL� INSTITUTIONAL OR k{EALTH CARE FACILITIES � <br /> BE RPPROVED BY Tf1E STATE OF WASHINGTON. APPLICANTS WITH SUCH JO85 NUST SHOW THE STATE APPROVED PLANS BEFORE A ' <br /> CI1Y OF EVERETT PF:RMIT WILL dE ISSUED. � <br /> (n, i <br /> -� .�� NOTE: MIRING IN NON-DKELL�NCS IS REpUIRED TO �E IN CONDUIT. I <br /> I <br /> � � I HEREBY CERTIFV THAT I HAVE FEAD AND� EXAMINED THIS ! <br /> � � APPIICATION AND KNOW THE SAME TO BE TRUE AND COPRECT.ALL <br /> PFOVISIONS OF UWS AND ORDINANCES GOVERNING TNIS TYPE OF <br /> WORK WILL BE COMPIETED WITH WHETHER SPECIFIE� HEi7EIN OFi <br /> NOT. THE GRANTING OF A PEFMIT DOES NOT PRESUME TO GIVE <br /> -.. .1UTHORITV TO VIOLATE OF i.ANCEL THE PflOViSIONS OF ANY <br /> OTHER STATE OF IOCAI UW REGUTATING CONSTRUCTION OF THE <br /> PERFORMANCE OP CONSTRUCTION.THAT I AM AUfHOFRED BY THE � � <br /> OWNEF OF THIS PqOPERTY i0 PERFOfiM THE WOFK FOR WHICH FEE <br /> ..,. '„ APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 1 B.21 RCW AND 296.200 WAC. <br /> � <br /> 1 / <br /> 'w � � .. .��/ . � <br /> .._I I X / , � , � ��. <br /> / , _' <br /> 5 ature � �ace - � .� <br />� �----'—_' _ <br />