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APPLICATION FOR ELECTRICAL HERMIT <br /> 4 W7r CITY OF EVERETT <br /> WILDING DIVISION <br /> 3200 CEDAR STREET <br /> 259-8810 EVERETT. MA 98201 <br /> :s L[✓,avxro�HS+� /yN/5' 6�/,.�-fit✓ it'r� � c-+�-y- Lri� 9�P�o•� EY'! Z32 ? <br /> Mail Addre5sLIty Cate rip hone <br /> tenant Mail Address <br /> City __7t_ati7r,p one <br /> ZQ cotcf <br /> tl ec trice bConitc for a dress ty +State/ p hone tate cense o, <br /> Non tract r ce o or ropos se ofu:T{ngr- <br /> 2 so y SW El^r 1O L1 /n/c, <br /> ro ect ress <br /> Discription of Work To Be Done: <br /> NOTE: WAC 296-46-140 REQUIRES THAT PLANS FOR ELECTRICAL WORK AT EDUCATIONAL, INSTITUTIONAL OR HEALTH CARE FACILITIES <br /> BE APPROVED BY THE STATE OF WASHINGTON. APPLICANTS WITH SUC" JOBS MUST SHOW THE STATE APPROVED PLANS BEFORE A <br /> ,CITY OF EVERETT PERMIT WILL BE ISSUED. <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO BE IN CONDUIT. <br /> I HEREBY CERTIFY THAT I HAVE RLAD AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO P•-RFORM THE WORK FOR WHICH FEE , <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br /> X �Rrx� �y �C' a- as-1-1 <br /> Signat ac ^� Date <br /> �3�, 3 / <br />