Laserfiche WebLink
�.r�l <br /> ARPLICATIQN FOR ELECTRiCAI. PERMIT <br /> c�Tv oF �err <br /> WIIDING DIVISION <br /> 3200 CmAR $TREET <br /> EVERET7, MA 9 Oi <br /> 259-8tJ10 <br /> J�,- �7'ro,v;G 33�� _r- „B.� � u4 9�szo� �3Y-33os <br /> 6wner Mai Address ty tate ip hone <br /> enant ai ddress ity tate ip hone <br /> �'����Z�Gc�� �=�G�.T. �3�0 .5nuT1� 2j� /xvG fvcr.T.0 'L(i �t9203 .1i27E!/ UlVl1 (:�' C !7'l/1�L <br /> ectricEi` �a l.`ontractor �faiT�tldi�e.s—��ty�tate Zip hone tate Cicen�� <br /> �/��� � V � �(L G <br /> ontract n ce o Wor � � ��roposef Use ot tl�,n ding — <br /> 3 Y CJo I 6.i <br /> roject Addrr.ss / <br /> Oiscription of Work To Be oo��: /(�e;,� � r�,1.7:�1,���� - cL � ire, <br /> _��_�.._� � <br /> lY�GO� iT�n <br /> NOTE: IYAC 296-46-740 REOUIRES THAT PL4N5 FOR EL[CTRICAL 'NORK AT EDUCATIONAL, INSTITUTIOIJAL OR HEALTH CARE FACIU TIES <br /> E1E APPROVEJ BY TNE STATE OF WASNINCTON. APPLICANiS WITH SUCH JOL'S MUST SNOW THE STATE /�PPRDVED PLANS �EFORE A <br /> CITY OF EVERETT PERMIT WILL OE ISSUED. <br /> NOTE: WIRINC IN NON-DWELLINCS IS REOUIRED TO BE IIJ CON�t11T. <br /> I HEREBY CERTIFY THAT I HAVE READ AND� EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE ANO CORRECT.ALL <br /> PROVISIONS OF UWS AND ORDINANCES GOVERNING 1HIS TYPE OF L�{: <br /> WORK WILL BE COMPLETEO WITH WHETHER SPEGFIED HEREIN OR J ,, �-- <br /> NOT. THE GAANTING OF A PERMIT DOES NOT PRESUME TO GIVE � J l. <br /> AUTHORITY TO VIOLATE OR CANCEL TH[ PROVISIONS OF ANY <br /> OTHER STATE OR LOCAI LAW REGUTATING CONSTRUCTION OA THE <br /> PERFORMD,NCE GF CONSTRUCTION.7HAT I AM AUTNORRED BY THE � <br /> OWNER OF THIS PRGPERTY TO PERFOFM THE WORK FOR WHICH ✓i� <br /> FEE c,y <br /> APPLICATION IS AIADE AND I COMPIY WITH THE STl.TE <br /> CONTRACTORS LAW 18.2%RGW AND 296.200 WAC. <br /> �(� i / <br /> C.� �r C�rr�,.}...,.� �Uf/if '—� L. I1 <br /> $iqnature Date � l� / <br />