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\ <br /> 1 <br /> �� � <br /> A�x <br /> c N <br /> >Htn <br /> M <br /> H � <br /> �y� APPLICA� .JN FOR ELEGTRICAL .'ERMIT <br /> H� <br /> 0 9y b cin or �rscTr <br /> ouiiniwc orvisiuN <br /> �,�p(] 3200 C�AR STREET <br /> H[+9� � 3 EVQIETT, MA 98201 <br /> G�� O \ �/, <br /> N � 1 v <br /> �H� 259-8810� V <br /> yL7 H � r'' RA ,� // 3 'f��e N.E. �9[r s�,��/ tate '�p 9B»i (<Ss So/J <br /> � Phone <br /> �yr ner �N Hai Address �'y <br /> � y tty tatc. ip one <br /> �y enant a� dress <br /> y3 r �5 1�+.N.f 1; s���v • � 98z7o 6 S5�S33S INEED 4 VC. <br /> [ �t�'�n.0 � � tate p hone tate ice�ise o. <br /> ectrica�'ontractor Aai �dtlre;s Y <br /> a Jb.� roposedUse oi uui d�g <br /> �ontract r ce o Wor <br /> ,/'��' <br /> p (,v1c��i1J <br /> roject Gdress ( � <br /> Discription of Work io Be Done: L <br /> .�G`Itu 'I i Jn �(S U JC�J . <br /> ' ' <br /> ' ' �— <br /> _ �__— <br /> ' 1 <br /> 1�I �� <br /> ' t NOTE: BE�APPROVED�BY THEuSTATETOFTWASHINGTON.ELf.PPLICANTS WITHTSU�CHCJOOSrJtU5TI5HOWTTHE STATERAPPROVEDCPLANSABEFOREEA <br /> 1 ' CITY OF EVERETT PERMIT WILL BE ISSUED. � <br /> � <br /> '=' NOTE: WIRING IN NON-DWELLINGS IS REOUIRED TO BE IN CONDUIT. <br /> wI I HEREBY CERTIFY 7HA7 I HAVE F1EA� AND' EXAMINED THIS <br /> � APPLICATION AND KNOW THE SAME TO BE TRUE AND C01.RECT.ALL <br /> ' PflOV1510NS OF lAWS AND ORDINANC=S GOVEPNING THIS TYPE OF <br /> �' y�IpqK WILL BE COMPLETED WITH WHETHER SPECIF�ED HEREIN OR <br /> AVTHORITYRTOTV OLA�TEACR CANCEiE7 E ROVES ONSTOF A'NY <br /> �,' pTHER 57ATE OR LOCAL LAW AEGUTATING CONSTRUCTION OR iHE _ ' <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTIIJRIZEq BY TNE . ! <br /> �j �qppJLICAOTION�SISRMADE ANDPEHCOMPI.Y W�OHKTF'.�Ep STAT�E FEE <br /> CONTRAGTOFS lAW 19.Z�RCV:AND 29fi.200 WAC• <br /> 1 <br /> � ���� �1 Date <br /> Si�nature / ��D/� <br /> q I <br /> 3 <br />