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��� <br /> a � -_.. <br /> ��� <br /> ��� <br /> y APPLICAi�iON FOR ELECTRICAL PERMIT <br /> xp <br /> H <br /> � HG <br /> � cin oF e�aerr <br /> M �<MV�E3�7T <br /> BIIIIDING DIVISION <br /> Q� 32D0 CmAR STREET <br /> ��„�� / EVERETT� MA 98201 <br /> H <br /> M 259-88f0 <br /> u / r/ p <br /> ��' E^la��r/I-/ ��S�i�`�°,/ i7 ' v ,�d X 5�/�� �/x'..�C�il� lU�/ '�'!��?G�, v��5'�- 7�,�1j_ . <br /> � r+ ner Mai ddress ity tatel ip hone <br /> �GO <br /> [A <br /> enant ai E ress ity tate ip one <br /> � ectn ca�ontractor Mai dfess ity tate ip one tate icense No <br /> //�SLC(�t/L✓` . ?� <br /> ontract rice o or ro�se o ui d ng <br /> 3.� �r ����s <br /> ro ect dress _ <br /> Discription of Work To Be Done: // L � � � � '� '""t� �'�'•� v/L'�� <br /> 1 1 <br /> '�/ <br /> / 1 �. <br /> '�' <br /> ; NOTE: WAC 296-46-740 REOUIRES THAT PLANS FOR ELECTRICAL WORK AT EDUCATIONAL, INSTITUTIONAL OR HEALTH CARE FACILITIES <br /> r BE APPROVED BY THE STATE OF WASHINCTON.� APPLICANTS WITH SUCH JO85 MUST SHOW THE STATE APPROVED PLANS BEFORE A <br /> " CITY OF EVERETT PERMIT WILL BE ISSUED. <br /> '� � NOTE: WIRING IN NON-DWELLINGS IS REOUIRED TO BE IN CONDUIT. � - � � <br /> �'� . <br /> � I HEREBY CERTIFY THAT I HAVE READ AND' EXAMINED THIS <br /> f� APPLJCATION AND KNOW THE SAME TO BE TFiUE AND CORRECT.ALL <br /> ' WORKSWILL EFCOMPLETED WIDTIHAWHETH RVSPEC�FIED HERE N OR <br /> � NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> � AUTHOPITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR IOCAL LAW REGUUTING CONSTRUCTION OH iHE � I <br /> ;�' PERFORMANCE OF CONSTRUCTION.THAT I AM AUiHORIZED BY THE <br /> � OWNER OF THIS PROPERTY TO PEflFORM THE WORK FOR WHICH FEE <br /> qpP�ICATION IS MADE AND I COMPLY WITH THE STATE <br /> �-� CONTRACTOFS lAW 1827 flCW AND 296.200 WAC. <br /> I <br /> X��t��/l���ti-w�.., 3 -��/��3 � <br /> Signature Date <br />