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^C7 <br />F�y <br />��x <br />C H <br />�Hx� <br />yZH <br />oxo <br />�rj N 'il <br />V1 H[+ <br />t�] O L�] <br />H l7 <br />H b7 O <br />G1� C� <br />H <br />zy <br />� i-+ H <br />C7 C/� <br />O H <br />oqtyrn <br />�7 � C�7 <br />HO� <br />� s <br />i i"j <br />_l<yy! �i� <br />259-8810 <br />O : C�U,U <br />APPLICATION FOR ELECTRICAL PERMIT <br />�a� � /"�'' T <br />ress <br />CITY UF EVFRETT <br />6UILDINC �IYISION <br />32u0 C�PR SiREEi <br />EVERETT, MA 96201 <br />lj��f� tY P hone <br />enant � � �4a�1 ddress tate i <br />� f :z t. <br />itL ` >!�e?�7 l`avtil �it/� CiJ�%'LcTT �5S�77o .G�i.c.�4.vc'�2e`r7:• � <br />�-]/l.0 � hC�- T � 7 one tate 1ren5e No. <br />��J <br />�ti�GZi <br />lontract Price o Work <br />� <br />L-ricn�%T <br />j rv ��1 l> .. ��vz S L <br />Proposed se o Building <br /><- <br />/��j G .� < <. — /c� <br />�iscriptian of Work To Be Donc: �_ '! �� � � / �� � ��� � <br />j,t� U�� �1�1/J 157JF.e /�c�//% � c�V ! � c <br />NOTE: WAC 296-46-140 REOUIRES THAT PLANS fOR ELECTRICAL WORK AT EDUCATIO�IAL� R�STITUTIONAL OR HEALiH CARE FACILITIES <br />BE APPROVED BY THE STATE OF WASHIMGTON. APPLICANTS WITN SUCH J0�5 MUST SHOIV THE STATE APPROVED PLAtiS BEFORE A <br />CITY OF EVERETT PERh11T WILL 6E ISSUED. <br />NOTE: WIRING IN NOIV-DWEILINGS IS REUUIRF.D 70 8E IN CONDUIT. <br />I HEREBY CEFiTIFY THAT I HAVE READ AND� EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CCFiPECT. ALL <br />PROVISIONS OF LAWS AND ORDINAtJCES GOVERNING THIS NPE OF <br />WORK WILL BE COldPLETEO WITH W!iETHER SPECIFIED HEREIN OR <br />NOT. THE GFANTING OF A PERMIT DCFS NOT PflESUME TO GIVE <br />OTHER STATE OR LOCAL LAW REGUTATING CONSOTRU � ON OR THE <br />PERFORMANCE OF CUNSTRUCTION. THAT I AM AUTHOFIZED BY THE <br />OWNEF OF THIS PROPERN TO PEfiFOPM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRA TORS LAW 18 �7 RCW AND 296.200 WAC. <br />X/�� �•_-„ . L%� 7�.z 7- S- z_ <br />Signatur� Oate <br />FEE �7� " <br />