Laserfiche WebLink
APPLICATION FOR ELECTRICAL PERMIT <br /> cin oF �xerr <br /> BUILDING DIVISION <br /> 3200 CEDAR STREET <br /> EVERETT� MA 38201 <br /> 259-8810 Z 5'Fs-�G 1� <br /> �M�C ��n , lTC', Q 1 ��"((il �a�erQv� �ve� qkLG�-3//� <br /> owner Mail Address ity tate rip � hon� e <br /> enant / �i ddress ity tate Zip hone <br /> � (lJ V1 C��� <br /> ETectrical onCractor MaiT—Tddress ity tate ip hone tate icense o. <br /> R�-��r�e��,� �a � <br /> ontract Price o ork roposed Use o Building <br /> ���f�(Q�_La v�-� loa r�, <br /> ro,7ect ddress � <br /> Discription of Work To 8e Done: O ►7(] (�Q P. � .CV 1�i� �1' `i�OWv SG(��.V II') <br /> �uses " -� � ��,� (' Ci� ������ e, � � �2a.-�,vic�e� <br /> �ev�-�ode, <br /> NOTE: WAC 296-46-140 REpUIRES THAT PLANS FOR ELECTRICAL WORK AT EDUCATIONAL, INSTITUTIONAL OR HEALTH CARE FACILITIES <br /> BE APPROVED BY THE STATE OF WASHINGTON. �APPLICANTS WITH SUCH JOBS MUST SHOW THE STATE APPROVED PIANS OEFORE A <br /> ,CITY OF EVERET7 PERMIT WILL �E ISSUED. , � <br /> NOTE: WIRING 1'N NON-DWELLINCS IS REQUIRED TO 8E IN CONDUIT: <br /> I HEREBY CEflTIFY THAT I HAVE READ AND' EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE�F <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESUtdE TO GIVE <br /> AUTHOFITY TO VIOLATE OR CANCEL THE PFOVISIONS OF ANY <br /> OTHER STATE OR LOCAL lAW REGULATING CONSTRUCTION OR THE � <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED 8Y THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH FEE <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 7827 CW AND 296.200 C. <br /> x � _ � -�c 3 7� <br /> .�;: �� <br /> Si ature Date <br />