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��y � ,,, <br /> iO �1 x � �� '�"� ' �. <br /> y �� 5 APPLICATION FOR ELECTRICAL PERMIT <br /> ky � I <br /> c�Tv oF everserr <br /> �y� oui�niNc o�visioN <br /> ��� 3200 CmAR STREET <br /> EVERETT, MA 98201 <br /> O �..i d 259-8810 <br /> c� <br /> �'�g Leal,o��l c.JT_ �oi3ox 1(�4s �.u ,,.Ic��� rec� t-u1� `�$2.�5 7�I5- 3$ 7 � <br /> ryy�..�� w�c� MaiT Atldress i t�tate7 p hone <br /> t"y <br /> t�i� y <br /> enant ai ddress ity tatei ip hone <br /> g�ti <br /> qg�« <br /> �" J�' 2q�/�e�.J J$ `� IZ inn��� Cfer�c �(�/d !f� 1,..�°(1er<uc 335�-2.So7 Scuu�, , l0�//tG <br /> y ecEi trical �ontracto��t���.-ess—�it�tate p hone taeeZicense No. <br /> HOCNi� <br /> _ 3. Z�C� S . r. iZ <br /> ontract rir.e o or roposed se o ui ding <br /> y`�S Z � �j�2h�(�'xjp� lAl/Q <br /> �ro�ec�ress <br /> r <br /> Discription of Work To Be Done: J , � IZ— ���� u. � S�12 l/� L e ' <br /> / 1 <br /> t�1 <br /> � � NOTE: WAC 296-4E-140 REOUIRES THAT PLANS FOR ELECTRICAL WORK AT EDULATIONAL, INSTITUTIONAL OR fiEALTH CARE FACILITIES <br /> 1 ' BE APPROVED BY TNE STATE OF WASHIN,TON. APPLICANTS WITH SUCH JOBS MUST SHOW THE STATE APPROVED PLANS BEFORE A . <br /> CITY OF EVERETT PERMIT WILL BE ISSUED. <br /> ' NOTE: WIRING IN NON-DWELLINGS IS REpUIRED TO BE IN LONDUIT. <br /> ' I HEREBY CERTIFY THAT I HAVE READ AND' EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND COFRECT.ALL <br /> ' ' PfiOVISIONS OF IAWS AND ORDINANCES GOVERN�NG THIS TYPE OF <br /> 1 ' WOAK WILL BE COMPLETED WITH WHETheR SPECIFIED HEPEIN GR <br /> NOT. THE GFANTING OF A PEFiMIT OOES NOT PRESUME TO GIVE <br /> � AUTHORITY TO VIOIATE OR CANCEL THE PROVISIONS OF ANY <br /> �' OTHER STATE OR LOCAL LAW REGUTATING CONSTRUCTION Oq THE �U <br /> PERFORMANCE OF CONSTRUC710N.THAT I AM AUTHOF2ED BY THE � C <br /> 1�" OWNER OF THIS PFOPERTY TO PERFORM THE WORK FOR WHICH FEE J <br /> � APPLICATION IS MADE AND I COMPLY WITH TH[ STATE <br /> CONTRACjDfi W 1827 RCW AN 296.200 WAC. <br /> ' / <br /> �� `j 3 f 9 Z. <br /> �- � Sig ature Oate <br /> �7.5'� 9 <br />