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APPLICATION FOR ELECTRICAL PERMIT <br /> �/ cin oF Ev�xErr <br /> n� f1UILDING DIVISION <br /> 3200 CmAR STREET <br /> p 9� EVEliE77� MA 98207 <br /> A <br /> �y y 259-8810 <br /> i: � <br /> K' O ` 'trtL.:...;1 ( . / %��...!' �" ��;', <br /> H Cti wncr •Pf9i Atldress ity tate ip Phonc <br /> oxo <br /> �a H � � � - . ,,_ � i <br /> b1 M "i ' /l tr. r � ' ��... •{ +.�,.' � b c.<� i�i. � ':��'_.,:i • ._J':.'�—'• '1/�/ <br /> ��p.'� enant Mai Edress �ty tate p hone <br /> H C7 / <br /> ".�l O t� � ��� ��. �S �'� i�/.��' /C�1/� /i'� >G %?--.(1 -'-JZcJ' �E�/�G /1FCi= <br /> MCdc.+ ectrica ontractor Mai� d� t�ate Iip one tate icense� <br /> p� c� r� '37- H3<e' <br /> H . . 6... "7y <br /> 7.M� '.7;;—'•i � ����r �� „ r� <br /> >y �✓-' ` . <br /> t^M y ontract n ce o Work Proposed Use o � uilding <br /> g�' H �. � � �- ,,� � , ,,�. <br /> �d m ���:�� i„ « - - < <br /> �� ro�eCt Addre55 <br /> y � <br /> H G W Oiscription of Work To Be Done: ��-� � �� ��''� =�� ' `' <br /> � « ,� � ��1,��✓ -/ �� � l <br /> r _ <br /> I CJ <br /> I �� NOT�: WAC 296-4G-740 REOUIRES THAT PLANS FOR ELECTRICAL WOP.K AT EOUCATIONAL� INSTITUTIONAL OR HEALTH CARE FACILITIES <br /> 6E APPROVED 8Y THE STATE OF WASHINGTON. APPLICANTS WITH SULH JO85 MUST SHOW THE STATE APPROVED PIANS BEFORE A <br /> ,CITY OF EVERETT PERMIT WILL �E ISSUED. , <br /> NOTE: WIRING IN WON-DWELLINCS IS REOUIRED TO �E IN CONDUIT. <br /> I �1 <br /> 1 HEREBY CEflTIFY THAT I HAVE READ AND� EXAMINED THIS <br /> APPLICATION AND K1�OW THE SAME TO B[TRUE AND CORRECT.�LL <br /> �1� PROVISIONS OF L1WS AND OR�INANCES GOVERNING iH15 TYPE OF <br /> � WOFK WI�L BE COMPLEfED WITH WHETHER SPECIFIED HEREIN OR <br /> NOT. THE GFANTING OF A PERMIT �OES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOIATE OR CANCEL THE PROVISIONS OF ANY <br /> � OTHER STATE OR LOCAL lAW REGULATING CONSTRUGTION OR THE �/ <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORI'LED 3Y THE }J <br /> ��� OWNEA OF THIS PROPERIY TO PERFORM TH[WORK FOR WHICH FEE - <br /> APPLICATION IS MADE AND I COh1PLY W�TH 7HE STATE <br /> - CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br /> ,,; •+�r �: . ��l��Y - /�� � �' �i L <br /> 'u� ,;� ;� - Signature Date � . <br /> .4� ' <br /> '� Y.•.5i)::)t,�� . <br /> - �'�'Yrr.'r' _ <br /> •�•��1`�•�4�i• � <br /> F��'ti�,i}} .. <br />