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� <br /> APPLICAT ION FOR ELECTRICAL PERMIT <br /> C�TY OF EV[RETT <br /> &11LDIHG D�VISION <br /> 3200 CmAk STREE7 <br /> x�� EVERETT, MA 98201 <br /> [:� <br /> ��'�y 259-8810 � <br /> r z�' t'Ju P l i ��u�� t1 i\.�7 P�°-�,^1'I I�,1 �IP;,s� ,�940 1io�� S� Ir�erc f f . �✓,a `�����j �S�-?6d�a <br /> y �3 �rner Mai Address City Ca e ip Phone <br /> � H� <br /> �°a �� SG;ti�r <br /> y H enant Mail ddress ity tate ip Phone <br /> Z�''" � <br /> o „g, � S�MQ � <br /> ectrical ontractor Mai Address ity tate ip hone tate �cense o. <br /> 8 ' <br /> Q�o �/ fUJ !y -r <_ �� i <br /> H , <br /> ontrat Price o ork Proposed Use of uilding <br /> i � <br /> r �"i y .���� I!O IL� � t � � . . <br /> y H Project Address <br /> ge� �c. <br /> � �� Discription of Work To Be Done: � � (�€re�I,r �FS��E t��� �� <br /> HOv�i ��0� � RPw' (1Y-'f�\iCB..3 Ir �wf�1 r*,��;rn G/'CCt_ /1U;'��1, �+�41. oT _ , <br /> (1�(�4 ('T� rFcE'�� 1h' ��,�,� �r.�r)�" __f`poltii. 1fv��1 C(;'� �'� <br /> � �? - � n' � ��5� � � <br /> l ` I <br /> i <br /> �a � ' <br /> NOTE: WAC 296-46-140 REOUIRES THAT PLANS FGR ELECTRICAL WORK AT EDUCATIONAL, INSTITUTIONAL OR HEALTH CARE FACILI71E5 . <br /> BE APPROVED BY THE STATE OF WASHINGTON. APPLICANTS WITH SUCH JOBS MUST SHOW THE STATE APPROVED PLANS BEFORE A �� <br /> CITY OF EVERETT PERMIT WILL BE ISSUED. , � <br /> +�°� ! NOTE: WIRING IN NON-DWELLINGS IS REOUIRED TO BE IN CONDUIT. � <br /> 0 I I HEREBY CERTIFY THAT I HAVE READ AND' EXAMINED THIS � <br /> " APPLICATION AND KNOW THE SAME TO 0E TRUE AND COFREC7.ALL <br /> PROVISIONS OP LAWS AND ORDINANCES.GOVERNING THIS TYPE OF '�. <br /> 'NORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> �� "' NOL THE GRANTING OF A PERMIT DOES NOT PRESUMF TO GIVE <br /> -+ AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> � � OTHER STATE OP.LOCAL LAW REGUl.4TlNG CONSTRUCTION OR THE <br /> pFqfOAMANCE OF CONSTRUCTION.THAT I AM AUTHOFRED 8Y THE ���, 5 G� <br /> E, "1 OWNEF OP THIS PROPEF'N TO PERFGFM THE WORK FOR WHICH FEE � <br /> -- APPIICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTOFS LAW 1827 PCW A �296200 WAC. <br /> �,.�)1 X �/, ��L��h � �� — 30- cf <br /> n��/�, � <br /> Signature �ate . ', � �. <br />