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i <br />, �� � <br /> H <br />' � HC~i� '�� ,- . <br /> ��� APPLICATION FOR ELECTRICAL PERMIT <br /> H �J <br /> '�M'� <br /> y � CITY OF EVEREI7 <br /> y �yr, 6UILDING DIYISION <br /> 3200 CmNt STREET <br /> � � �7 EVERE7T� MA 98201 <br /> � �g 2ss-ssro <br /> �'� � 6ss-o3�7 <br /> .vE �. ��nti,�ii ��/2Zl �ap�e S �.— �er2eff 4/9 �'3'zol 2S`�T�35.26 <br /> ,�,� y� ner Mai Adtlress ity tate ip Phone <br /> My <br /> g�' <br /> H <br /> n d y enant kai ddress ity tate ip hone <br /> ��N <br /> i .y� y. ectrical ontractor Mai ddress ity tate ip hone tate icense o. <br /> CYa?a�fe - .77'orCacYP� <br />. ontract nce o Wor roposetl e o�Tlui ding <br />��;.,��' �� � � � ��y /`1oa/e �t F�enett- � <br /> � ti�� ro]ect ddres� <br /> . s+:�;:-t�� . . <br /> i ��::;�__� .. , , <br /> Y=�� �lf7w �U � 7'O LF� Sta �� �2v'�C/t .So � �inr.� <br />�� ,�,j.. .- � . � � Discriptioi of Work To Be Done: <br />. ��i:. - � � . � � <br /> ��&_C'`LYC��C��7-v in I-wnrror � _.L QN� /� w A r,p/t n�F r' i(fF�-r CiS C� <br /> 12 -3l - 4 2 V�( DC[ihP/I n0�{��o�r✓tirl'�P ���hes c�h�( l+�C�r s 7'0 /S'��Se an<( <br /> `� �7 {� n � Q <br /> / ' C9klZ_�L_�qfF,rR �etn I��rn �1Me F'/Zo++� �i� .S '7�0 �re ?ncPE � C!l c �t! ���e �. <br /> " � Tlis� I�P -C'ohnpi'T �Js�,,,�i7 ���,�re ��i- (w�us �e,�oRe �C'[� <br />� i ; NOTE: WAC 296-46-140 REOUIRES THAT PLANS FOR ELECTRICAL WORK AT EDUCATIONAL� INSTITUT�ONAL OR NEALTH CARE FACILITIES <br /> BE APPROVED DY THE STATE OF WASHINGTON. APPLICANTS WITH SUCH JOBS MUST SHOW THE STATE APPROVED PLANS BEFORE A <br /> � ,CITY OF EVERETT PERMIT WILL BE ISSUED. <br />, '�' NOTL: WIRING IN NON-DWELLINGS IS REQUIRED TO 8E IN CONDUIT. <br /> 1�/ <br /> I HEREBY CERTIFY THAT I HAVE REAO AND' EXAMINED THIS <br /> '� APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> �' PflOVI510NS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> WORK WILL BE COMPLEfED WITH WHEfHEA SPECIFIED HEREIN OR <br /> � NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> '� AUTHORITY TO VIOLATE OR CANCEL THE PFOVISIONS OF ANY <br /> OTHER STATE OR LOCAL LAW REGUTATING CONSTRUCTION Ofi THE <br /> �' PERFOFMANCE OF CONSTRUCTION.THAT I AM AUTHORRED BY THE <br /> OWNER OF THIS PROPERTY TO PERFOFM THE WORK FOR WHICH �`����� <br /> � APPLICATION IS MADE AND I COMPLY WITH THE STATE FEE � 1_) <br /> ' CONTRACTORS lAW 1627 RCW AND 296.200 WAC. <br /> ' X <br /> _ _ /- � `t'3 <br /> �Signature Date <br />� '4�:��:;�,•� . <br /> . . . . �^ 1� I �il <br /> 11 <br /> / I <br /> � <br />