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jn . <br /> (C'dtYi>�.'. <br /> � <br /> �:� <br /> rtanmm. <br /> �� ��I � e <br /> APPLICPT��N FOR ELECTRICAL rERMIT <br /> � � <br /> cin oF evexxerr <br /> 9y BUIIDINC DIVISION <br /> �"A H 3200 CmAR STREET <br /> 9 H V1 EVEREfT� MA 98201 <br /> y �H 259-88 f 0 �I�d ti - 13 l�� <br /> � H� <br /> � H� L w ��2i�rFr ��t� SY;t�[I(�J ('� B+x 13 �<o SN�N�a,Jrr I�+�•,� 4,�ZY,� GG,�- 179'7 _ <br /> W H Mail Address ity tate �p Phone <br /> Owner <br /> � H� �/�`T y �t tate/Zip rhone <br /> � �� lenant Mai ddress Y <br /> zN�' {A SG✓ ��Eci cc /�ll0 2J.�+y SiJ� CVvtc-.i (,✓h �Pz�)� 33Y-t7PZ fF�NrEeltz,.•n <br /> tate � hone tate icense o. <br /> > H ectrical ontractor Mai Adtlress �tY P <br /> r ~y `� 30�0 . 00 SINGC� FAMt�Y ,(�C-�IJcNcr- — <br /> N <br /> ~ ontract rice o Work Proposed Use o uilding <br /> C] C V� <br /> � `�' � y�� y �onrl� !��i v� <br /> y0 y ro,7ect Address /1 <br /> � Discription of Wo�k To Be Oone: ���2� �-� .f�/`��LL �/�Mrey K�$$�O�Ne� '- .ZJU lrM�� <br /> � <br /> �s , <br /> '�s <br /> `�� <br /> IIOTE: WAC 296-46-140 REOUIRES THAi PLANS FOR ELECTRICAL WORK AT EDUCATIONAL� INSTITUTIONAL OR HEALTH CARE FACILITIES <br /> BE APPROVED BY THE STATE OF WASHINGTON. APPLICANTS WITH SUCH J085 MUST SHOW THE STATE APPROVED ?LANS BEFORE A <br /> CITY OF EVERETT PERMIT WILL �E ISSUED. � <br /> �s NOTE: WIRING IN NON-DWELLINGS IS REOUIRED TO BE IN CONDUIT. <br /> �^� I HEREBY CERTIFY THAT I HAVE READ AND' E%AMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TFUE AND COFRECT.ALL <br /> ��s 1 PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> WOFK WILL BE COMPLETED WITH WHETHER SPEC�FIED HEPEIN OF <br /> � � NOT. THE GRANTING OF A PERMIT DOES NOT PRESUM1IE TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR LOCAL LA�'`1 FEGULATIN6 CONSTflUCTION Ofi THE � `�O U <br /> r pERFORMANCE OF CONSTRUCTION.THAT I AM AUTF!OFRED 8Y THE <br /> �I� OWNEfl OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH FEE J <br /> APPLICATION IS MADE AND I COMPLY WITH THE STPTE <br /> CONTRACTORS LAW 1827 FCW AND 296.200 WAC. <br /> � � � ' <br /> X �� JA,J 1 `1 �`l�J <br /> Signature Oate <br />