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APPLICATION FOR ELECTRICAL PERMIT <br /> � CITY OF EVEREfT <br /> BUILDING D�VISION <br /> 3200 CEDAR STP.EET <br /> EVE7tETT, MA 98201 <br /> 259-8810 <br /> K.FI.".1/ .( 't7�tY/it� �''S3//V /L/% C.L �•'' � ��'l7G.U'i °N� 't/�f �^lj M . � �.-} <br /> vnner Mefl Addreas <br /> ty tate � one <br /> i <br /> V/�".r/✓r <br /> enant a ress - <br /> ty tate p one <br /> Ut� <br /> ectr ca ontractor a resa � tata p one tete cense o, <br /> �.�c'F•�C'c' <br /> ontreet r ce o or ropuae ee o u ng <br /> i JG'`� (`NF._T�l/.r <br /> ro ect arosa - - <br /> DtacripNon ot Mork To Be Donee _ •c�'ct�F L/�i',1�%,E /2S��i..�� <br /> s <br /> NOTE: MAC 296-46-140 REpUIRES THAT PLANS FOR ELECTRICAL MORK AT EDUCATIONAL, INSTITUTIONAL OR HEALTH CARE FACILIT�ES <br /> BE APPROVED BY THE STATE OF MASHINGTON. APPLICANTS WITH SUCH JOBS MUST SHOW THE STATE APPROVED PLANS BEFORE A <br /> CITY OF EVERETT PERMIT MILL BE ISSUED. .. I <br /> NOTEi MIRINC IN NON-DMELLINCS IS REOUIRED TO BE IN CONDUIT, ��� <br /> I HEHEBY CERTIFY THAT I HAVE READ AND' EXAMINED THIS <br /> APPLICATON AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> PROVISIONS OF UWS AND ORDINANCES GOVERNIN6 THIS TYPE OF <br /> WORK WILL BE COMPIETED WITH WHETHER SPECIFIED HEREIN OR <br /> NOT. THE ORANTINQ OF A PERMIT DOES NOT PFESUME TO GIVE <br /> AUTHORITY TO VIOUTE OH CANCEL THE PHOVISIONS OF ANY ' <br /> OTHER STATE OR LOCAL UW RE6UUTIN6 CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUT}fORRED BY THE <br /> OMMER OF THIS PqOPERTY TO PERFORM THE WORK FOH WHICH � <br /> APPLICATION IS MADE AND I COMPLY WITH THE ST,\TE <br /> CONTRACTOFS LAW 18.27 RCW AND 298.200 WAC. <br /> X � � / <br /> Signature Date <br /> ��� �� <br /> �. <br />