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APPLICATiON FOR ELECTRICAL PERMIT <br /> cin oF �Err <br /> BUILDING DIVISION <br /> 3200 CmAR STREET <br /> EV[REfT, MA 98201 <br /> 259-8810 <br /> /�LA ,� I�Fi»r���„2��2 Fv�rzc{�-/f�� �CV��a�V �N,Q- � �'Z O J�y.jy �0 <br /> ner ai d ress �ty �tate/rip hone <br /> Clc,�, R.an�+nu/�� /�// Euk=.E.Fii�/.�u� rr�a.�rl�t ?rt//a /�'/9�'Z ��/-iz�Z <br /> Tenant —AaiT-7�ddress ity tate Zip hone <br /> ���.1.�{�i�:u 2/,✓'�„Il�� G r`r(���� �/ ,��t ��f�Y/� i 9J 37oJ rL/cCTLi <br /> ectr ca Z`ont ctor ai d ress ity tate ip hone tate icense o. <br /> / / 13zML <br /> �r1, ''�00 °" ,F,��ifi�Tiii>»�6i,� �'�i5 <br /> ontract r ce o or roposed se o ui ding <br /> ����F���t�,�U/ - g���ZF� j,v,� - vy9�z <br /> Discription of Work To Be Done: <br /> NOTE: WAC 296-46-740 REOUIRES THAT PLANS FOR ELECTRICAL WORK AT EDUCATIONAL, INSTITUTIONAL OR HEALTH CARE FACILITIES <br /> BE APPROVED BY THE STATE OF WASHINGTON. APPLICANTS WITH SUCH JOBS kUST 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 /> i HEREBY CERTIFY THAT I HAVE READ AND' EXAMINED THIS <br /> APPUCATION AND KNOW THE SAME TO BE TRUE AND COFRECL ALL <br /> PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFlED 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 OP IOCAL lAW REGUTATING CONSTRUCTION OR iHE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PFOPERTY TO PEFFORM THE WORK FOR WHICH FEE ���' <br /> APPIICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTOFS LAW 1827 RCW AND 296200 WAC. <br /> X /a�GC� :� z <br /> Signature Date <br /> �-,�d%/ <br />