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Y <br /> �: <br /> m ����'''!!! � y� <br /> �� � i <br /> t"H a� � <br /> H�i-� .-.:.j vR� <br /> ��� APPLICATi��'; FOR ELECTRICAL `NERMIT <br /> Hy <br /> �xp cin oF �xerr <br /> y b G� BUILDINC DIVISION <br /> O N '( 3200 CmAR STREET <br /> �y�g EVERE7T, MA 98207 <br /> n" n 259-88Y0 <br /> � H� ���5 �D ✓ioj� .�376 Fuvr-f!' �r� . �j�zo7 3,�3- 7�72 <br /> Cyy ner ai Gdress ity�tate Zip hone . <br /> h�N <br /> r enant Mai ddress ity tate �p hone <br /> HN <br /> yo � sr- S <br /> E�ectrical ontractor ai ddress ity tate ip hane tate icense o. <br /> SI'R <br /> o�aci rice o or roposed Use o ui ding <br /> 2z /� t'Q.ju �, br�. A� E��✓�n` �y,.os � <br /> ro)ec��ddress � <br /> Discription of Work To Be Done: ZC�C� �W1,� �`�Pr^ ��'GIG S r �� . <br /> �v � <br /> • l�/��J. 3 <br /> ��� — <br /> ��� <br /> � � <br /> ��' NOTE: WAC 296-46-140 REOUIRES THAT PLANS FOR ELECTRICAL WORK AT EDUCATIONAL, INSTITUTIONAL OR HEALTH CARE FACILITIES �. <br /> '�1 BE APPROVED BY THE STATE OF WASHINGTON. APPLICANTS WITH SUCH JO85 MUST SHOW THE STATE APPROVED PLANS BEFORE A , <br /> CITY OF EVERETT PERHIT WILL BE ISSUED. <br /> '_' NOTE: WIRING IN NON-DWELLINCS IS REOUIRED TO bE IN CON[IUIT. <br /> ;` <br /> '�1 1 HEREBY CERTIFY THAT t HAVE READ AND' EXAMINED THIS <br /> ' APPLICATION AND KNGW THE SAME TO BE TRUE AND CORflEC?ALL <br /> PpOVISIONS OF UWS AND ORD�NANCES GOVERNING THIS TY E OF <br /> � . WORK WILL BE COMPLEfEO WITH WHEfHER SPECIFIED HEREIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESUh1E TO GIVE <br /> '�; � AUTHORITY TO VIOLATE OR CANCEL THE PFOVISIONS OF ANY <br /> � OTHER STATE OR IOCAL LAW FEGUTATING CONSTRUCTION OR TNE <br /> PERFOfiMANCE OF CONSTRUC710N.THAT I AM AUTHOFIZED BY THE <br /> '� OWNEA OF THiS PHOPERTY TO PERFORM THE WORK FOR WHICH FEE �>� <br /> APPLICATION IS MADE ANO I COMPLY WITH THE STATE <br /> �' CONTflACTORS lAW 18.27 RCW AND 296.200 WAC. • � <br /> r � e <br /> /' � <br /> X %/���,�'��-il�.� /�"/t�"`>Z � <br /> � <br /> �ignature �a[e <br /> .3���1� <br /> � <br />