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s; <br /> �.� <br /> , <br /> ,�, <br /> , APPLICATION FOR ELECTRICAL PERMIT <br /> cin• oF ereeEtr <br /> OUILDING DIVISION <br /> y n H 3200 CmAR STREET <br /> '�C�,C��1 EVERETT� MA 98201 <br /> ro�x 259-8810 <br /> C, H <br /> N9�CA V1 !� M .w� p s <br /> 3 � '(-i1� 11J >�1���--1'C�l'�> �i����� `"11AGn,ril�n •n�j�� 4� 1."%�� tiil�� �1 �7��C ��� �'-vi;; <br /> Kn `-bnner �� ddress ��ty- "-�te1 ip <br /> H77 _ �-- <br /> /! �� <br /> � y~ enant ai tlress �ty tate p honc <br /> � �� ectn cal ontractor ai ddress ity tate ip hone tate icense o. <br /> ��g <br /> � y� 1-�->r�� <br /> ontract Price o Wor roposed se o� u ding <br /> Z <br /> H H . � i �- l.l� t�c (' � c�- <br /> g y i..i i i����c�i `_�f�4J� •1'S � .� n 1 N' � i.`�i._C:, <br /> l7 q V1 roject Address <br /> ��y D+scription of Work To Be Done: ��" '� � On `�I��k�U �iL� CUM��,��y"� v Qv�� M •,.X�- <br /> HOV� <br /> � ri ry. � a�a , ;" ,� � �i M� Y r' r �» <br /> I <br /> 1' � <br /> i! <br /> I <br /> '�, � NOTE: WAC 296-46-140 REOUIRES THAT PLANS FOR ELECTRICAL WORK AT EOi!CATIONAL, INSTITUTIONAL OR HEALTH CARE FACILITIES �, <br /> 9E APPROVED BY THE STATE OF WASHINGTON. APPLICANTS WITH SUCH JOBS MUST SHOW THE STATE APPROVED PLAHS BEFORE A <br /> �! CITY OF EVERETT PERMIT WILL BE IS�UED. <br /> NOTE: WIRING IN NON-DWELLINGS IS REOUIRED TO BE IN CONDUIT. /��� <br /> '1 �� 1/ <br /> _ � n � D <br /> I HEREBY CERTIFY THAT I HAVE READ AND� EXAMINED THIS � <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND CORFECT.ALL „ <br /> � PROVISIONS OF IAWS AND ORDINANCES GOVERNING THIS NPE OF <br /> +I'' WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEflEIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PflESUME TO GIV'c <br /> AUTHOiiITY TO VIOLATE OF CANCEL THE PFOVISIONS OF ANY <br /> "" OTHER STATE OH LOCAL LAW FEGUL4TING CONSTPUCTION OR THE <br /> �.t..� PEFF'JRMANCE OF CONSTRUCTION.THAT I AM AUTHORRED BY THE <br /> CWNER OF THIS PqOPERTY TO PERFORM THE WORK FOR WHICH FEE <br /> qpPLICATION IS MADE ANO I COMPLY WITH THE STATE <br /> ' '�' CONTRACTORS LAW 18.27 RCW AN�296.200 WAC. <br /> x j � - �' � ,, <br /> � Signature ` Date <br />