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� <br /> APPLICATiJN FOR ELECTRICAL rERMIT <br /> cilr oF evExerr <br /> euiininc oiv�sioH <br /> szao c� srn�r <br /> • EVERETT, MA 98207 <br /> 259-8810 <br /> L��Git� �i-1;77- ���//C' /�'/ ,(��� /�2;� /5-���-l��� `l��/ - -L32� <br /> S�ner ail7d res�s �ty tate 2�p one <br /> enanE a ress ty tate p one <br /> c�/JCOc/G /3�/.zo 8�s1`-,�/rcN�= �,.E�N�L�f� 9fiD?�/ �o-�%�%1/3 7�v�1�2��P�A <br /> ica�ConEractor a ress it�tate r p one tate cense o. <br /> ll � <br /> ontract r ce o or ropose se o u ng <br /> ' S7� 7 ��k�•,z� L�h� <br /> ro ect dress � <br /> ! Dtscription of Mork To Be Done: �f�J ��•Sf' ��� ��� C� � %� <br /> i <br /> NOTE: MAC 296-46-140 REpU�RES THAT PLANS FOR ELECTRICAL WORK AT EDUG:'IONAL, INSTITUTIONAL OR HEAI.TH CARE FACILITIES <br /> BE APPROVED BY THE STATE OF MASHINGTON. APPLICANTS WITH SUCH JOBS MUST SHOW THE STATE APPROVED PLANS BEFORE A <br /> ,CITY OF EVERETT PERMIT MILL BE ISSUED. � <br /> NOTE: MIRING IN NON-DWELLINCS IS REOUIRED TO BE IN CONDUIT. <br /> I HEREBY CERTIFY THAT I HAVE READ ANO' EXAMINED THIS <br /> APPUCATION AND IaIOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> PAOV�$�ONS OF LAWS AND OR�INANCES GOVERNING THIS TYPE OF <br /> WORK WILL BE COMPLETED WITH WHE7HER SPECIFlED HERE�N OR <br /> NOT. THE GRANT�NG OF A PERMIT DOES NOT PRESUME TO GIVE <br /> � AUTHOFITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OH LOCAL U1W REGUUTING CONSTRUCTION OH THE <br /> PERFORMANCE OF CONSTAUCTION.THAT I AM AUTHORIZED BY THE � _ <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH p� � <br /> APPIICATION IS MADE ANO I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 18.2�RCW AND 296200 WAC. <br /> X �l�/1���'/<,� /:��� Y> <br /> Signature Date <br /> 3q3�5 <br />