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APPLICATION FOR ELECTRiCAL PERMIT <br /> /� cirr or Eveeerr <br /> (� dU1lDING DIVISION <br /> � �� ` 3200 CmAR STREET <br /> EVERE7T, MA 98201 <br /> y� 259-8810 <br /> q �� �., 1 ��L�' , <br /> � .� , ��,�- , <br /> �i H Cn �'/���-� ; (� I' l;,�4_ c `/v ;'l . . . _ r`�l' �i , r- i-'��i'�-m <br /> y � N wncr t4ai1 Address ltty tate ip hane <br /> K n <br /> H X1 <br /> oxo <br /> � H � enan�- Mai tltlress �ty [ate ip hone <br /> U7 H <br /> !�.w3Z � ' ) f%ir� u.:- ¢ iC ?J'7 <br /> C•] Q !/)Llf lJri• �S ElCc l'.�� �jd/ r/G" %� 12.�('r'eNU�� ) ) y '6`1:;; <br /> 0 H d Llec[rica ontractor MaiT ddresA s lUty�tate Z�p �hone $ta�icense f1o. <br /> H � g �� r-� <br /> �w n <br /> �y� Lon�r3ct n ce o ork _ roposed Use of �ui din9 <br /> HH �1 � :�/ Jli[ t�=.t T�N i/�-. f-- c .��,,�- <br /> g y ro�ect ddress <br /> H <br /> C�C❑7[� <br /> � C�7 t'� Discriptior uf Work To Be Uonc: /y L11) A (i/'[ .� -'�I > i i,' Y� <br /> l+] <br /> 2 H fn <br /> HOfn F�e%�.. /) [ /Gi�ii.i .j C //.'�c ii 1`" 7y�^% C�i�t: . l <br /> � <br /> �_' <br /> - ��pTE: WAC 296-46-140 REpUIRES THAT PLANS FOR ELECTRICAL WOflK AT EOl1CATI0NAL� INSTITl1TI0NAL OR HEALTH CARE FACILITIES <br /> ' �E APPROVED OY THE STATE OF WASHINGTON. APPLICANTS WITH SULH JOBS MUST SHO'A THE STATE APPROVED PLANS BEFORE A <br /> i __ CITY OF EVERETT PERMIT WILL BF ISSUf.O. <br /> NOTE: WIRING IN NON-DWELLINGS �5 REpUIRED TO DE IN CONDUIT. <br /> . f I�I i HEREBY CEFiTIFY THAT I HAVE READ AND EXAMINED THIS <br /> APPIICATION ANO KNOW THE SAME TO BE TRUE AND CORRECL ALL , '(-\ <br /> PROVISIONS OF lAWS AN�OROINANCES GOVERNING THIS TYPE OF ��,. <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OFi <br /> f� NOT. THE GFANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> I� aUTHORITY TO VIOLATE OR CANCEL THE PRO�ISIONS OF ANY <br /> � OTHEA STATE OR IOCAL LAW REGULATING CONSTRUCTION OF THE <br /> PERFOfiMANGE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE � (,��� <br /> OWNEF OF THIS PROPERTY TO PERFOFM THE WORK FOFi WHICH FEE ?�� � <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> ��I. CONTRACTOFS LAW 18.27 RCW AND 296.200 WAC. <br /> X % � . / � n <br /> ��, ; � ��.,::. r, >_ 1 <br /> -Signature , Datc �.�\ <br /> � Q <br /> ��� � <br />