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� <br /> ! <br /> APPI.ICA1�vN FOR ELECTRICAL PERMIT � - <br /> �/ cin oF Eversrrr <br /> OUILDING DIVISION <br /> ,.y,.�y 3200 CmAR STREET <br /> [-�j EVERETT� MA 90201 <br /> C�H 259-8870 <br /> >Hx Cn <br /> rr-� 9� �-' i � c � I o I� 5 I aZ 17 � 51�� ���P S F Ll(j���tl" �-'�� `I��'�>� 3�5'-1 9`/`/ <br /> 7 x H 1� <br /> wner Mai ddress it�y�tate ip hone 'I <br /> H xl <br /> i <br /> "�G H� � <br /> y Z� enant Mai ddress ity ta[e ip hane <br /> H � <br /> �i o I <br /> oryi� �'� �:i �d1c� FFC• G CC SOr u�" /l�C �<,r ,u,�' C��/�- G,5 `<' 3/ $ �OsC- cic <br /> � n ectncal ontractor a� ddress ity t te 1 p`7c, %n tate icense o. I <br /> ��'g s�-��� <br /> x ~� ontract rice o Wor � � P 9 � <br /> � y x Pro osed se o Bui din <br /> gyH i�l r;lc���o�c-1 I���e ������f �'�� <br /> n d y ro ect ddress <br /> � �� n i <br /> x yy �iscription of Work To Be �one: ZC'�! q�✓1 � C S �� I\ ����°'� — . <br /> H O cn <br /> , � <br /> v <br /> �� <br /> 0 ' <br /> NOTE: WAC 296-46-140 REpUIRES THAT PLANS FOR ELECTRICAL WOflK AT EDUCATIO.'7AL, INSTITUTIONAL OR HEi.LTH CARE FACILITIES <br /> � � 8E APPROVED BY THE STATE OF WASHINGTON. APPLICANTS WITH SUCH JOBS MUST SHOW THE STATE APPROVED PLANS BEFORE A � <br /> � 1 CITY OF EVERETT PERMIT WILL BE ISSUED. , , � i <br /> =: ,� <br /> NOTE: WIRING IN NON-DWELLINGS IS REOUIRED TO BE IN CONDUIT. <br /> "" '""' I HEREBY CERTIFY THAT I HAVE READ AND' EXAMINED THIS �. <br /> APPIICATION AND KNOW THE SAME 70 BE TRUE AND COFiRECT.ALL i <br /> 1 pqOV1510NS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF � <br /> ; ""� WORK WILL BE COMPLETED WITH WHETHEA SPECIFIED HEREIN OR <br /> 0 NOT. THE GAANTING OF A PFRMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOIATE OA CANCEL THE PROVISIONS Of ANY � .� <br /> OTNER STATE OR LOCAI lAW REGULATIN6 CONSTPUCTION OR 7HE �. <br /> r� PERFORMANCE OF CONSTAUCTION.THAT I AM AUTHORIZED BY THE � '� <br /> ,�,y „� OWNER Of THIS PFOPERT' TO PERFORM THE WORK FOR WHICH FEE S � ' �� <br /> APPLICATION IS MADE AND I COAIPLY WITH THE ST.1TE <br /> CONTRACTORS LAW 1827 RCW AND 296200 WAC. I � <br /> f._' ' X j! � /�,�j�. I, � <br /> �� f'ij'! il .���_ �, �(�Cf I /" �f� � <br /> �ature Datc .. <br /> �j <br /> � i+ <br /> ,`)y�t� D� ;;' <br /> �'. <br /> ?i <br /> i. <br /> I f4 <br />