Laserfiche WebLink
� <br /> � <br /> 1 <br /> APPLICAI�N FOR ELECTRICAL r'ERMI'� <br /> i ; <br /> ,� �� cin oF eveRErt I <br /> x � (� OUIIDIHC DIVISION � <br /> 3200 CED�R STREET <br /> y n H EVERETT, MA 98207 <br /> ttl k��]� <br /> y y 259-88 f 0 <br /> ,ox1x <br /> rHx� ��r,�, ,, I o,nn IOZ 7 �9'� ���' S_f ���-;a// c�=%� l��n� 33ff�-/ly�/ <br /> y9 H ner Mai Add�ess Lity Cate �p hone <br /> x <br /> � H 7nJ <br /> oxo <br /> 'i1 y H enan� ai ddress �ty tate �p honc <br /> SL S /, <br /> � ��i ��S Clo-cc' lf�. y7G� SeTy/�; �I /y��� v%���' ��!' �1b170 �Sy-��3 SZQS< -/2/�'X <br /> l7 ectrical ontractor ai ddress ity tate/ ip hone State License IVo <br /> ��g 5t=/� <br /> z H� ontract rice o or roposed Uso o ui ding <br /> H <br /> r <br /> � H H I �C C IF,'1 L,:'U�� � lv �a <br /> / �l�c ���,r�/ <br /> � y �oject ddress � � <br /> H <br /> Oq GC CB Z� i <br /> 3 [�7C Discription of Work To �e Done: z� /i�L��n �� � J�� " ����� . <br /> [s1 C+1 <br /> Z H[A <br /> H O fn . <br /> � <br /> 4 <br /> 1 <br /> 1."'� <br /> �'! NOTE: WAC 296-46-140 REOUIRES THAT PLANS FOR ELECTRICAL WORK AT EDUCATIONAL, INSTITUTIONAL OR HEALTH CARE FACILITIES <br /> BE AP?ROVED BY THE STATE OF WASHINGTON. APPLICANTS WITH SUCH J095 MUST SHOW THE STATE APPROVED PLANS BEFORE A <br /> � � <br /> U TY OF EVERETT PERMIT WILL BE ISSUED. � � <br /> !�._� NOTE: WIRING IN NON-DWELLINGS IS REOUIRED TO BE IN CONDUIT. ' <br /> I HEREBY CEflTIFY THAT I HAVE READ ANO' cXAMINED THIS �, <br /> 'd�► APPUCATION ANO I'.VOW 7HE SAME TO BE TRUE AND CORRECT.ALL <br /> PFOVISIONS OF lA1VS AND OFDINANCES GOVERNING THIS TYPE OF ' <br /> wORK WIIL BE COMPIEfED WI7H WHEfHER SPECIFIEG HEREIN OR <br /> �°'� NOT. THE GRANTING OF A PERMIT DOES NOT PpESUME TO GIVE <br /> !� AUTHOFITY TO VIOLATE OR CANCEL THE PFOVISIONS OF ANY <br /> OTHER STATE OR LOCAL IAW REGULATING CON57pUCTION OR THE <br /> PERFORMANCE OF CC45TRUCTION.THAT I A61 AUTHOf71ZED BY THE � <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR'NHICH FEE ' S �� <br /> APPLICATION IS MADE AND I COh1PLY WITH THE STATE <br /> �'- "� CONTRACTOflS lAW 1827 RCW AND 296.200 WAC. <br /> � <br /> � ' <br /> �t � X �, ,�;/�'�� ��� o�( �l 9� i Z <br /> Sig ature Date <br /> 7 ��j ����� <br /> � <br />