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APPLICATIQN FOR ELECTRiCAL PERMIT <br /> cin or �v�a�rT <br /> JU{LDING DIVISION <br /> 3200 CmAR STREET <br /> � �� EYERLTT, MA 98207 <br /> p � x 259-8810 <br /> � <br /> H ! <br /> -�i "3�' r ',n c, � ' ' C 7�l}��3��.� <br /> �s � � ?),� ����� %� C u 1z�z�3 <br /> r-� � 3e GlsG� Yh�/)AlC/5 �'�(s' �!c!u �tY taTe p none <br /> � n ner Mai Address <br /> H�1 <br /> '�U H "�U -- �ty tate ip honc <br /> y � enant Ma� ddress <br /> �yx / <br /> yd (`��� ���� — tate p hone tate icenseNo. <br /> ETectn ca ontractor 1a�1 �d re=�� �tY <br /> n <br /> � � g �-� � � ��� <br /> �� � <br /> xy� ontract rice o Wor Proposco J,c of Uu�lding <br /> F x 'r, <br /> H H - <br /> � <br /> gcn �;ll,, I F'!�_- ;� ' � r� � '�' — <br /> ~ ro�ect Cd�ess � <br /> C] C7[A � p <br /> ��i �t�+�l � �� �9� /U•� I�1�1v Gii'ti'S �v I(�: C, pt„> cytc�f <br /> Discription of Work 7o Be Done: IUI / L <br /> H O(yii / � / r ;/l�L <br /> 011'� r � l�!_ l�y SUN✓bDLt� lG���� l� /5 ���LeG��GIl� U�l G, CdYIS _/1�' <br /> � l'6LVcc� GUr �� �'6Nu �` � v�, ll9G�r�C'r�C2,� 7" i,U�f�c-1 GU�S U,S��� <br /> � <br /> � � j,Gr� �/✓G7ctLG� <br /> ��� <br /> I <br /> � NOTE: BECAPPROVED�BY iHEUSTATETOFTWASFi'INGTOR ELAPPRI(:ANTS WKTHTSU�CHCJOBSNMUSTISHOWTTHE SiATE�APPROVED PLANSADEFOREEA <br /> I �� CITY OF EVERETT PERMIT WILL BE ISSUED. <br /> NOiE: WIRING IN NON-OWELLINGS IS REQUIRED TO BE IN CONDUIT. <br /> � _ <br /> �� <br /> ' I HEAEBY CEfiTIFY THAT 1 HAVE REAO AND� EXAMINED THIS <br /> AFPLICATION AND KNOW THE SAME TO BE TFUE AND�ORPECT.ALL <br /> PROVISIONS OF LAWS AND ORDINANCES GOVEFiNING THIS NPE OF <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEPEIN OR <br /> �_ NOT. THE GPANTING OF A PERMIT OOES NOT PRESUME 70 GIVE <br /> OTHER S ATE OFi LOCAL LAW REGULATING CONSTR'UCOT ON Ofl THE _ <br /> I�i PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHOFi1ZED BY THE - <br /> � OWNER OF THIS PROPERTY TO PERFOFM THE WORK FOR WHICH FEE _ _ <br /> I �1� ppPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> � CCNTRACTORS LAVd 1927 FCW AND 296.200 WAC. <br /> X /��� �i /� L�/J L��/2 <br /> / ( <br /> Sigrl6ture <br /> Date <br /> 3`���3 <br /> --- --- -----�� <br />