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APPLICATION FOR ELECTRICAL PERMIT � <br /> � CITY OF EVE72ETT <br /> BUILDING DIVISION <br /> 3200 CmAR 51REET <br /> EVERETT� MA 98201 <br /> 259-88f0 <br /> HA-�',c n�5a.0 � i7 >ic_vf.�1-' T� fl.� �vi.��rr �sz - /69D <br /> ner ail ddress ty tate p one <br /> ��� � <br /> enant ai ddress �ty tate ip one <br /> G6B -��¢6 <br /> .f R-i t- 's �Gl°G 9� /9��� sd�Ohis /o,G 9 99r� EL�4.'c�Z�3 o g <br /> ecE1�1 ontrac� tor ai dress city state Zip one ta—te Licen�o. <br /> S � I'� <br /> ontract r ce o or ropose se o ui ing <br /> y�o � 7 Si�IYE'fT�'D Lv� <br /> ro ect ddress <br /> DSscription of Work To & Done: ,� x T£.0?> j f G U i l. d �/I� � <br /> _ � �1) i/l/ A—nri 7'/O,a4 <br /> NOTE: WAC 296-46-140 REOUIRES THAT PLANS FOR ELECTRICAL WORK AT EDUCATIONAL� INSTITUTIONAL OR H[ALTH CARE FACILITIES <br /> 8E APPROVED BY THE STATE OF WASHINGTON. APPLICANTS WITH SUCN JOBS MUST SHOW THE STATE APPROVED PLANS BEFORE A <br /> CITY OF EVERETT PERMIT WILL 8E ISSUED. • <br /> NOTE: MIRING IN NON-DWELLINCS IS REpUIRED TO BE IN CONDUIT. <br /> I HF.REBY CERTIFY THAT I HAVE REAO AND� EXAMINED THIS <br /> APPIICATION AND KNOW THE SAME TO BE TRUE ANO CORRECT.ALL <br /> PFOVISIONS OF U1WS AND ORDINANCES GOVERNING THIS TYPE OF <br /> NlORK WILL BE COMPIETED WITH WHE'R1ER SPECIFlED HEREIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHONITY TO VIOUTE OH CANCEL THE PROVISIONS Of ANY <br /> OTHER STATE OR IOCAL UW REGUUTING CC'7STRUCTION OH THE <br /> PERFORMANCE O�CONSTRUCTION.THAT I AM AUTHORIZED BY THE g,��OD <br /> OWNER OF THIS PROPEHTY TO PERFORM THE WORK FOR WHICH FEE <br /> APPLICATION IS MADE AND 1 COMPLY WITH THE STATE <br /> CONTRACTORS UW 1 B27 RCW AND 296200 WAC. <br /> �i 5`{�_`5 <br /> X n ..�' � <br /> Signature Uate <br />