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APPLICAI �ON FOR ELECTRICAL PERMIT <br /> c�1v oF �err <br /> BUIIDINC DIVISION <br /> TF_ 3200 �mAR STREET <br /> . E�'ERETT, MA 98201 <br /> 259-8810 <br /> �t7./�/P J%/// /�Jh ��/� /.G�77/7ar[7 ,� ��Bh.e�-� � <br /> nner t�ail ddre� ss ity tate ip hone <br /> �uJtl-t �^ <br /> enant ai d ress ity / �J` tate ip ane <br /> //E`�'�' 1.'�lHS �5/' <br /> 02 y �DU f" ��e r�c� ,/.��.3 �6�j �5�/�L� Gv°u5�7 �&-�5�— ��c57 �UU✓�Of/O�D <br /> Erectrica ontractor ail- d�ss ity tate ip hone $tate icense o. <br /> J//7q�-E' �NJ/^/� <br /> ontract n ce o or � ro ed se o uilding -� <br /> ��� 9 �a�d4h � <br /> ro�ect ddress � <br /> Discription of Work To Be Dane: �Q� .rs/X�J OPf"f�/C� � fJiC� �I.CS'��n"y ! <br /> ,� i <br /> Guh'�//S `t Pe' t�/ir2 �Q�s� �r�e«/ , <br /> NOTE: WAC 296-46-740 REpUIRES THAT PLANS FOR ELECTRICAL WORK AT EDUCATIONAL, INSTITUTIONAL OR HEALTH CARE FACILITIES <br /> BE APPROVED BY THE STATE OF WASHINGTON. APPLICANTS WITH SUCH .i085 MUST SHOW THE STATE APPROVED PLANS BEFORE A <br /> .CITY OF EVERETT PERMIT WILL BE ISSUED. , � <br /> NOTE: WIRING IN NON-DWELLINGS IS REpUIRED TO BE iN CONDUIT. <br /> I HEREBY CERTIFY THAT 1 HAVE READ AND' EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND COflFECT.ALL <br /> PROVISIONS OF U1WS AND ORDINANCES GOVERNING THIS TYPE OF <br /> WORK WILL BE COMPLEfED WITH WHE7HER SPECIFlED HEREIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLA7E OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR LOCAI LAW FEGUTATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTFiUCTION.THAT I AM AUfHORIZED BY THE �j <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR Y/HICH FEE <br /> APPLICATION IS MA�E AND 1 COMPLY WITH THE STATE <br /> CONTRACTORS LAW 18.27 flCW.4N�296.200 WAC. <br /> X � <br /> c��. ,i �titr � <br /> Signature Oate <br /> j ���j <br />