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��� <br /> H ' <br /> Q � . <br /> y�� � �. <br /> K y� ��3APPLICA�ION FOR ELECTRICAL P�RMIT <br /> �y� � � <br /> y� � � cin oF EveaErr <br /> O BUIIDING DIVISION <br /> 3200 CmAR STREET <br /> O�� EVERETT, MA 98201 �' <br /> ��g 259-8810 <br />' lsH� 353 - ! <br />; ty G /��.�[.e1 /�,(gG�i < o i� 2�3 d ,f-J/�N.tO `v�itr_v-� 38�� ? i <br /> �..� ner Mai Address —�ity tate Zip 'hone � <br /> g� <br /> H � <br /> o�cn �A-!? <br /> Tnant Mai ddress � �ty tate Zip ' one <br /> � GGS — <br /> y �. �lc�s /1�L!`-G Q3i,�� /P�"r`�T 1/f_ �'.<YGi1'�A�S/>• �p4G, �/�tc� ii� 29'SCIr '; <br /> Electrical ontractor Mai ddress ity tate ip ho7s ne Staie G cens�o. , <br /> S .__.� <br /> ontract r ce o Wor roposed se o ui ding � <br /> Z 2 30 �')')��tiu� <br /> ro�ect ddress <br /> Discription of Work To Be Done: �[� �J f}- �({-LT/�I�-/�r� � LC7 /�(s" � i <br /> �} O D/ ri a � i <br /> i <br /> � � <br /> ��' <br /> � � <br /> 1 ' NOTE: WAC 296-46-140 REpUIRES TNAT PLANS FOR EIECTRICAL WORK AT ECUCATIONAL, INSTITUTIONAL OR fiEALTH CARE FACILITIES <br /> � BE APPROVED BY THE STATE OF WASHINGTON. APPLICANTS WIT�i SUCN JOBS MUST SHOW TNE STATE APPROVED PLANS BEFORE A <br /> '�1 CITY OF EVERETT PERMIT WILL 8E ISSUED. , � i <br /> ' ' NOTE: WIRING IN NON-DWELLINCS IS REOUIRED TO BE IN CONDUIT. <br /> � <br /> � i HEREBY CERTIFY THAT I HAVE READ AND" EXAMINED THIS <br /> !�' APPLICATION AND I:NOW THE SAME TO BE TRUE AND CCFFECT.ALL <br /> � PFOVISIONS OF UWS AND OROINANCES GOVERNING THIS'fYPE OF <br /> � WORK WILL BE COMPIETED WITH WHETHER SPECIFIED HEREIN OR <br /> �' NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHOflITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> ' OTHER STATE OR IOCAL LAW REGUV�TING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTON.THAT 1 AM AUTHORIZED BY THE ��t�� <br /> OWNER OF THIS PpOPERN TO PERFORM THE WORK FOR WHICH FEE <br /> ' APPLICATION IS MADE ANO I COMPLY WITH THE STATE <br /> CONTRACTOFS U1W 18.27 RCW AND 296200 WAC. <br /> � i <br /> _ X� � �'� �� //�/�/�Z <br /> Signature �ate � <br /> �� / t <br /> ��, v � <br /> n :; <br /> � <br /> �1 <br /> � <br /> � <br />