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��;� APPLICATII�N F4R ELECTRICAL PERMIT <br /> CITY OF EVER[TT <br /> ,.y„ �� UUILDING DIVISION <br /> �i 3200 CmAR STREET <br /> p � � EVERETT, MA 98201 <br /> � H [~i� 259-881 D ,,n,���� <br /> �( p�7 { e. q <br /> r��C O � IlC 1 � ^��. � V�c A�c�A.�J v�C � ��oS� �_.,'e�-� �— W�. I��c' � <br /> O C� O ner M i ddress �ity tate ip hone <br /> 'sl r: hG <br /> VJ N <br /> ��p� enant ai ddress ity—�P hone <br /> H l7 � ' �[i- I�/,; /'C /�. . /53 <br /> ��g G��=.� r� s ;�� i � .�w���.�s-�.�� � s� �r� s�, ,� <br /> E e�ica ontractar 1atl�tldress ity [ate 2Sp B6 e State Licens�c�— <br /> H y , <br /> � y `�'�� � � <br /> �„� � on�tract nce o Wor roposed se o ui tlinc`�� <br /> g� I <br /> dv�i fi — we t�� �--(' <br /> �� � ro� c Address <br /> ��� \ ` ' " �' a <br /> Discription of Work To Bc Done: � 'he_ _ 1-c��t/� ' � S� � � i ��:-� (` <br /> J <br /> �� —�� L < r „� I c / y i/ ..� e .v, � 'z� �f <br /> � ") % � <br /> � — ,����� ���-b --��--c <br /> �� <br /> L� <br /> INOTE: WAC 296-46-140 REOUIRES TNAT PLANS FOR ELECTRICAL WORK AT EDUCATIONAL, INSiITUiIONAL OR HEALTH CARE FACILITIES <br /> � BE APPROVED BY TIiE STATE OF WASHINCTON. APPLICANTS WITH SUCH JO85 HUST SHOW THE STATE APPROVED PLiNS BEfORE A <br /> � CITY OF EVERETT PERMiT WILL BE ISSUED. . <br /> NOTE: WIRING IN NON-DWELLINCS IS REOUIRED TO BE IN CON�UIT. <br /> i �� <br /> I HEREBY CERTIFY THAT 1 HAVE FEAD ANO' EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO GE T9UE AND COFRECT.ALL <br /> y_I_1 PROVISIONS OF U1WS AND ORDINANCES GUVERNING h115 TYPE CF <br /> i�� WORK WILL BE COMPIETE�WfTH WHETHER SPECIFIE�HEflEiN OR <br /> I NOT. THE GRANTING OF A PERMIT OOES NOT PRESUME TO GIVE <br /> � AUTHORITY TO VIOLATE OR CANCEL THE PFOVISIONS OF ANY <br /> I � OTHER STATE OR IOCAI LAW AEGUTATING CONSTRUCTION OFi THE <br /> I PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED 8Y THE �� O� <br /> ; OWNEF OF THIS PFiOPERIY TO PEPFOfiM THE WOFiK FOR WHICH FEE G� <br /> � APPLICATION IS MADE ANO I COMPIY WITH THE STATE <br /> CONTFACTORS LAW 10.21 RCW AND 296.200 WAC. � <br /> �l <br /> X � / <br /> �/ ..�� ��`?�i�.i�/I� <br /> �ignaCure �ate <br /> �1 ,)�(� <br />