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APPLIC�,.�ION FOR ELECTRICA� PERMIT <br /> cin oF �v�aErr <br /> y C� UUILUING DIVISION <br /> x 3200 CmAR STREET <br /> C�7[jl y EVERETT� MA 982�T <br /> q�H 259-8870 <br /> t� L9C y 7 /� n — <br /> H Z� L/!1 �L�' S i > � � . '' /-f✓. ��/,.t'G � yiv� �iti':C�' �✓_i.7" lf.'G <br /> .� _• ✓LLJ � <br /> �C O ner� Mai Address �ity tate ip Phone <br /> H 7� <br /> o xo <br /> ";1 H"+J <br /> V1 H <br /> H t" enant Mai ddress ity tate ip hon�— ; <br /> zz� <br /> Oy� _! _�� - — <br /> � �g E7ectrical Contractor Mai ddress ity tate ip hone tate icensc o. � <br /> ~" � J�rs �.•l�'� --� E <br /> xH� . <br /> 9 H ontract n ce o Work roposed Use o Bu� ding � <br /> r�yHH i <br /> Cj �H � /" rV1C�� � � <br /> n dy r0�ect Address � � <br /> � �r /' / ! /� <br /> yHO N Di scription of Work To Be Done: /Y,��` � � � ��� ���5�, `�� C v L � � E� � <br /> . i <br /> i <br /> � <br /> 1 <br /> b <br /> �� i <br /> �1 <br /> NOTE: WAC 296-46-140 REOUIRES THAT PLAN� 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 PLANS BEFORE A i <br /> � � ,CITY OF EVERETT PERMIT WILL BE ISSUED. . <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO BE IN CONDUIT. � ( <br /> '� i �� <br /> _ ' I <br /> I HEREBY CERTIFY THAT I HAVE READ AN6 E:tAMINED THIS �I <br /> APPLICATION AN�KNOW THE SAME TO BE TRUE AND COflRECT.ALL . <br /> PFOVISICNS OF IAWS AND OR�INANCES GOVERNING iHIS NPE OF <br /> � '�' WOflK WILI BE COMPLETED WITH WHEfHEF SPECIFIED HEREIN OR ��, <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHOFITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY . <br /> OTHER STATE OR LOCAI LAW REGULATING CONSTRUCTION OR THE � / �, <br /> PERFOHMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE � '� <br /> �.. � OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH FEE �� <br /> APPUCATION IS A7ADE ANO I COMPLY WITH THE STATE � <br /> CONTRACTOFS LAW 1827 FiCW AND 296.200 WAC. i <br /> �,�� x �������° 1l�z�,,^. � � <br /> � ? .�.� �, � � �3� i <br /> Sig�ature Date ,9 I <br /> il <br />