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APPLICAT�N FOR ELECTRICAL rERNiIT <br /> c�n oF EVEaErr <br /> 6UILDING DIYISION <br /> 3200 CmAR STREEf <br /> , EVERETT, MA 98201 <br /> 2ss-sa�o <br /> 2��� SD�- Z4��� ��`f � -/3�s <br /> �neF Mai Address i��tate i� 'hone <br /> � 77G-CLvo <br /> Tenant � Mail� d� ity tate ip hone <br /> ���� <br /> ectrical ontractor Mai Address ity �tate Iip hone tate icense �Tlo.— <br /> ���SdD U� ���'�C ,� ���i— <br /> ontract Price o ork Proposed Use o uilding <br /> �rLll— ��^lJ�r✓'G72 ,�� �� u�!¢ <br /> �roject Address <br /> Discriptian of Work To Be Done: /�yj"/(/��'�/�/-6} �O � � �/Gx� <br /> � ��" `� -L�.��ed-�=c�e- I " /OU /timv Seru�«s <br /> � — <br /> NOTE: WAC 296-46-740 REOUIRES THAT PLANS fOR ELECTRICAL WORK AT EDUCATIONAL, INSTITUTIONAL OR HEALTH CARE FACILITIES <br /> BE APPROVED BY TNE STATE OF WASHINGTON. APPLICANTS WITH SUC{i JOBS MUST SHOW THE STATE APPROVEO PLANS BEFORE A <br /> ,CITY OF EVERETT PERMIT WILL BE ISSUED. , � <br /> NOTE: WIRINC IN NON-DWELLINGS IS REOUIRED TO BE IN CONDUIT. <br /> 1 HEREBY CERTIFY THAT I HAVE READ AND' EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND COfiRECT.ALL <br /> PFiOV1510NS OF IAWS AND ORDINANCES GOVERNING THIS NPE OF <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN Ofi <br /> NOT. THE GRANTING OF A PERMIT OOES NOT PflESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR LOCAL LAW FEGULATING CONSTRUCTION Ofi THE <br /> PEFFORMANCE OF CONSTP.UCTION.THAT I AM AUTFIOFIZEU BY THE � J U� <br /> OWNER OF THIS PROPERTY TO PERFOFM THE WORK FOR WHICH FEE /�� <br /> APPLICATION IS MADE AND I COM1IPLY WITH THE STATE <br /> CONTRA RS LAW 18.27 RCW AN�296.200 WAC. <br /> X <br /> Signature Date <br />