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�3 <br /> APPLICAI ��)N FOR ELECTRICAL r'ERMIT <br /> [17Y OF EVEREfT <br /> 6UIIUIi:G DIYISION <br /> y n h-i 3200 CmM STREET <br /> S C'� EVERETT, MA 98207 <br /> [•1 Cs1 <br /> ,o�5 259-88 i 0 <br /> >HC~/� l �/ <br /> C /, '7 ii, Q� �E'i`l9{.(�NC �,I�A� �oiE.i�7/ GvI? Cf�Zdi .jf .3-�%�� <br /> � �� (�1�� t�e� , � y ! � <br /> � Z� ��� Ma'1 daress � `C�ty Cate �p Phone <br /> H�1 <br /> � H KJ <br /> �H Mai dd�ess �ty ta[e ip hone <br /> enant <br /> H <br /> � z <br /> �O !>l�r�iJ �lL C . .3 �I ii.S//r_S <,� /�ni/�c�;��S Cc��2 ' YZ�� (.xJ.j-"�7 � .Z 5c.7.vr-/.�r.� ' <br /> � ~ ie�` ctrica ontractor Ma dtltess �ty ta[e/ ip hone tate �cense o <br /> � �g � �i <br /> �. � <br /> � Q i3ao , av �r�,��.1�� � <br /> zH3, on[r�'act�rice o Wo�k roposed Usc o ui 0 ng � <br /> 9 H Cl1 <br /> t" H H <br /> � � �C_5 !�l'r .a`r',c%— C,/�� <br /> d N Project AdOross <br /> ��� Dixription of Work io Be Donc: SPlOtif/ Sr�Qj /��1� �`T/� / — /✓L-���� .1����^�� <br /> H O tn <br /> /�S� A�C1��" /> ��F_'. :�L��6pM �^'J �i°i/-i _ <br /> `� �' I <br /> � � I <br /> NOTE: WAC 296-46-140 REOUIRES THAT fLANS FOR EIECTRICAL WJRK AT EDUCATIONALr INSTITUTIONAL GR HEALTH CARE FACIU TIES j <br /> ��"� ; BE APPROVED BY THE STATE OF WASHINGTON. APPLICANTS WITH SUCH JOBS MUSf SHOW THE STATE A?PROVED PLANS BEFORE A � <br /> �� �. ,CITY OP EVERETT PERMIT WILL �E ISSl1ED. , i <br /> NOTE: WIRING IN NON-DWELLINGS IS REpUIRED TO 6E IN CONDUIT. I <br /> ' � ' I HEREBY CERTIFY THAT 1 HAVE READ AND� EXAMINE� THIS I <br /> APPLICATION ANO KNOW THE SAME TO BE TFUE AND COflflECT.ALL 'i <br /> ( �i PROVISIONS OF L4W5 AND ORDINANCES GOVERNING iHIS TYPE OF <br /> WOfiK WILL BE COMPLETED WITH WHE7HER SPECIFIE�HEREIN OR <br /> ~ NOT. THE GPANTING OF A PEflM1T OOES NOT PRESUME TO GIVE <br /> AUTHOFITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY I <br /> ` O1NEfl STATE OFi IOCAL LAW FiEGULATiNG CONSTFUCTION OF THE � i <br /> �I PERFORMANCE OF CONSTAUCTION.7HAT I AM AUTHORIZED BY 7HE � <br /> OWNER OF THIS PROPERN TO PEPFORM THE WaRK FOF WHICH FEE �J . <br /> APPLICATION IS MA�E AND I COMPLY W�TH THE STATE �� <br /> CONTRACTOFS lAW 7827 RCW ANO 296.200 WAC. <br /> ����� X ��� ,<�1�� �� /;_�`-> 2� I <br /> � Signature �ate <br /> . �� � . <br /> (�' ' , <br /> I <br />