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A�� <br />� <br />Q y <br />��� <br />� <br />a�� <br />Cp N <br />� Q � <br />OM <br />Q�8 <br />ryH <br />N <br />[A <br />g�� <br />��� <br />: �� <br />�� <br />i L� <br />APPLICA��:JN FOR ELECTRICAL �ERMIT <br />� <br />� <br />� <br />cin or Ev�,._ <br />DUILDING DIVISION <br />3200 CmAR STREET <br />EVERETT� MA 98207 <br />� <br />�cic. 13�yzlc�✓ �l13 Lah,u- � <�w�� i�a-�a lsa - o�i✓�; <br />ne�+ r Ilat Atldress ity tate p hone <br />enant Mai Cdress ity tate ip hone <br />SeN�dt- �a(l`�iR�c. IIq�3'�b W�ic��Irr Rn ///aM-x LJF �%l�L7L 1�N'SS65 SI,�i,iaucceSti3N <br />�n ca ontractor ai dl�ss �ity �tate Iip hon-P e 3ta[e License Ho: <br />ontract ri;e o Wor Proposed Use o ui ding <br />Gru <br />Discription of Work To Be Done: ..��N pp� �� (e�� <br />_�— <br />NOTE: WAC 296-46-140 REpUIREC THAT PLANS FDR ELECTRICAL WORK AT EDUCATIONAL, INSTITUTIONAL OR HEALTH CARE FACILITIES <br />BE APPROVEp BY THE STA7: OF WASHINCTON. APPLICANTS WITH SUCH JOBS MUST SHOW THE STATE APPROVED PLANS BEFORE A <br />,CITY OF EVERETT PERMIT WILL BE ISSUED. , <br />NOTE: WIRING I" NON-DWELLINGS IS REpUIRED TO BE IN CONDUIT. <br />I HEREBY CERTIFY THAT I HAVE HEAO AND� EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE ANU COfiRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNINCi THIS TYPE OF <br />WORK WILL BE COMPLE7ED WITH WHETHER SPECIF�,ED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORiTY TO VIOLATE OFi CANCEL THE PROV;SIONS OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR 7HE <br />PERFORMANCE Of CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WNICH <br />APPLICATION IS A�E AND I COMPLY WITH THE STATE <br />CONTRACTORS LA 18.27 FCW AND 296200 WAC. <br />�V{�1 � �� � %3 <br />.a_���_ <br />S��r(ature , Date <br />i <br />FEE -�'-� <br />