Laserfiche WebLink
, <br /> APPLICATi�ON FOR ELECTRiCAL�PERMIT <br /> cin oF eveaErr <br /> y�� 6UILDING DIVISION � ' <br /> x 3200 CmAR STREET <br /> C�1 a y EVEREfT� MA 98207 <br /> C�H � 259-8810 <br /> H zr�-i ` �Ct V �LINlG G') � IV S � L)PGZ�'eE'v"�(L��t[r/ � //.2G-EIT �/ � <br /> �C y� � Mail ddress ��t� t� �P Phone <br /> oyH L, - z � , ` 353�3��33 <br /> y r enant Mail ddress City tate ip Phone <br /> � O� <br /> H t7 <br /> D e.v- <br /> � �� ectrical Contractor Mai ddress ity tate ip hone tate icense o. <br /> H V �C� Q� � ` �i�f <br /> 7, H3 � n�0 '� M <br /> � y z ontract ice o Work roposed Use o Buil ir.g <br /> �yHH <br /> p v'H � 7 O S I= L�c't -cc;-r �`'� ' <br /> n d� ro�ect Address <br /> � �[r*1 <br /> z y y Discription of Work To Bc Donc: - <br /> H O[n <br /> . .. . _�7`1,�,`_,S.�a-.r�J� r� n � F�`�\� ��t�.�—���d/'�• <br /> '�s' <br /> O�� <br /> !"�'9 v. IVGTE: WAC 296-46-140 REOUIRES THAT PLANS FOR ELECTRICAL N'ORK AT EDUCATIONAL, IYSTITUTIONAL OR HEALTH CARE FACILITIES <br /> �I BE APPROI'ED �Y THE STATE OF W.15fiINGTON. APPLICANTS WITH SUCIi J0�5 MUST SH07i THE STATE APPROVED PLANS BEFORE A <br /> CITY OF EVERETT PERMIT WILL 8E ISSUED. <br /> A 4 NOTE: WIRING IN NON-DWELLINGS IS REpUIRED TO BE IN CG4�U1T. <br /> !o <br /> I HEREBY CEATIFY THAT I HAVE READ AND� EXAMINED THIS <br /> �r` APPIICATION AND KNOW THE SAME TO BE TqUE AND CORRECT.ALL <br /> I � � PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS 7YPE OF <br /> �`� WOFK WILL BE COlAPLEiED YlITH WHETHGF SPECIFIED HEREIN Ofl <br /> NOT. THE GFANTING OF A PEFMIT DOES NOT PRESUME TO GIVE <br /> _ AUTHOFITY TO VIOLATE OFi CANCEL THE PROVISIONS OF ANY <br /> OTHEA STATE OF LOCAL lAW REGUTATING CONSTPUCTION OR THE <br /> f�; PEAFORMANCE OF CONSTFiUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH FEE � <br /> APPLICATION IS MADE AND I COMPLY WITH THE ^TATE <br /> �e CONTRACTORS IAW 18.27 FCW AND 16.200 WAC. <br /> �� <br /> X �� �W � � � <br /> � �gnature I �ate <br /> � <br />