Laserfiche WebLink
APPLICAI JN FOR ELECTRICAL ,�ERMrT <br /> ciTr oF EVEtttrr <br /> 9111LDINC DIVISION <br /> // 7�1 3200 CmM STREET <br /> 259-8810 / ��y %[/y� ��ETT, MA 98201 <br /> ��v�e ss -f-��«cu� GCJ��ccf'� �'�oc �///D��' �vC'`U� �z/p ,C�2U Q��r1 <br /> ner ai ddress ity tate ip hone <br /> !rI S. E. �„e,�etf lat� ll CJ� �" f3-Ib� <br /> �1.�� ��1Mr+aaaP �� � � �ptF � )�A C7l'> � 70�( <br /> 7enarC ` � ail Ad�re�s � it�tate Zip ��e <br /> /�o.�� 35�a�e. c.��. ��{ <br /> �i�� r � +�^� [: Lvu, Lu .+„�r�o� C��14 9 U-3-7 7y3�97U�i SIl.�AECLI��R� <br /> II ca l.ontractor ai ress ity tate p one tate icense o. <br /> (! �� 7 <br /> , �`�-- G�,�'cE <br /> Z mtract ' ce o or roposed se o ui ding <br /> ro ect ress . <br /> Discription of Mork To Be Dane: ��y.� �� �'�.� SpL.y�� �.hJ�E� bi (�/e�� /'vl 6,(��c,�f t�.� � � <br /> V <br /> Q�LI� U��Q�L�GDt�IC��. l 1 d��l�/ Ll/� - <br /> c <br /> NOTE: MAC 296-46-140 REOUIRES THAT PLANS FOR ELECTRICAL WORK Ai EDUCATIONAL, INSTITUTIONAL UR HEALTH CARE FACILITIES <br /> BE APPROVED BY THE STATE OF WASHINGTON. APPLICANTS WITH SUCH JOBS MUST SHOW THE STATE APPROVED PLANS BEFORE A <br /> .CITY OF EVERETT PERMIT X�LL BE ISSUED. . <br /> NOTE: WIRINC IN NON-UWELLINGS IS REOUIRED TO BE IN CONDUIT. <br /> I HEREBY CERTIFY THAT I HAVE fiEAD AND' EXAMINED THIS <br /> � APPLICATION AND qJOW THE SAME TO BE TRUE AND COHRECT.ALL <br /> PROVISIOM1S OF UWS 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 PRESUMF TO GIVE <br /> AI�THORITY 70 VIOUTE Ofi CANCEL THE PROVISIONS OF ANY <br /> OTMER STATE OH LOCAL UW REGULATING CONSTRUCTION OR lHE <br /> PERFORMANCE OP CONSTRUCTION.THAT I AM AUT40RIZED 8Y THE ? �� <br /> OWNER OF THIS PqOPERTY TO PEFFORM THE WORK FOR WHICH FEc <br /> APPLICATION IS MAOE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 1827 RCW AND 296.200 WAC. <br /> X 7r 5 <br /> gnature Dat <br />