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N <br /> � <br /> � � � �`� � APPLICAI ibN FOR EL.ECTRIGAL PERMIT <br /> K n <br /> O a O CITY OF EVERETT <br /> y � � r'� 6UIlDING DIVISION <br /> /�� 3200 CmAR STREET <br /> � WEYE/ZErI EVERETT, MA 98207 <br /> ca � <� <br /> °� � � 259-8810 <br /> � " � ��� 'l GU �' I�nJ zZ/� S� �� C�� /��` Z�Z �5�.� <br /> y <br /> H y wner Mail Address ity tate� ip Phanc <br /> S N <br /> (� O N <br /> C �. it tate i hone <br /> � ro Tnant Mai ddress Y P <br /> o vy, /' �/ � �/ ` n ! 9�,36/ �%/-ICXd=.rK�qS�lL�3 <br /> LJC,L�C.�4%..� �-J��- �FJ�3 5. L/. /�P�l�-!^'e0 J wc7 G 5�+`.�. <br /> ectrtcal ontractor Mat ddress ity tate tp ho��tate Cicense No. <br /> �J � <br /> fG� / OP�//OC7�M �- �✓��� S�,/.� . <br /> �ontract Price o ork � Propased Use o Building <br /> Z Zl � S "' Sf- 1=-c��'c7� <br /> ro�ect ddress <br /> i <br /> Discription of Work To Ue Done: � !7� /��C/��/��-� ' �S� L�'/0��� /L'�� <br /> i <br /> ' A�� /��L\ —_- <br /> ���i <br /> � <br /> _ <br /> , <br /> i �_,_ - <br /> __� <br /> NOTE: WAC 296-46-140 REOUIRES THAT PLANS FOR FLECTRICAL WORK AT EDUCAT�ONAL, INSTITUTIONAL OR HEALTH CARE fACILITIES <br /> IBE APPROVED �Y THE STATE OF WASHINGTON. APPLICANTS WITH SUCH JOBS MUST SHOW THE STATE APPROVE� PLANS �EFORE A <br /> �� CITY OF EVERETT PERMIT WILL BE ISSUED. <br /> NOTE: WIRING IN NON-�WELLINCS IS REOUIRED TO BE IN CONDUIT. <br /> � �� I HEREBY CERTIFY THAT 1 HAVE READ AND' EXAMINED THIS <br /> � APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> PROVISIONS OF LAWS AND OFDINANCES GOVERNING THIS NPE OF <br /> 4 � WORK WILL BE COMPLEfED WITH WHETHER SPECIFIED HEREIN OR <br /> I 1 1 . NOT. THE GFANTING OF A PERMIT OOES NOT PFESUME TO GIVE <br /> � AUTHOFITY TO VIOLATE Ofl CANCEL THE PFOVISIONS OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE . � <br /> I PERFOfiMAYCE OF CONSTRl1CTI0N.THAT�AM AUTHORIZED BY THE �j �- <br /> OWNEFi OF THIS PROPERTY TO PEflFOPM THE WORK FOR WHICH FEE <br /> _ ' APPIICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br /> X � (Gt13(' �— /� /�9_; <br /> 5 i gt(ature <br /> � Date <br /> . �� G> �'�� I <br /> J'�",' I <br /> i <br /> _ � <br /> �-- <br />