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Hnr� <br />�M <br />O � x <br />r�ay <br />K y '� <br />�H� <br />U1 H <br />t+7 O � <br />OHd <br />�r g <br />�I] Y (i <br />zy�� F-i H <br />gy <br />C� t7 fp <br />��t� <br />HOt�i� <br />P—' <br />arY� h� <br />CITY OF EVz'RETT DATE J-�_� <br />_ 1"�. <br />ELECTRICAL WIRING PERMIT APPLICATION FEE_j�__ <br />.�ua ADGRESS 9��g !n/-e<T �'Yi,a-ll �R°l(/� <br />TENT.NT /�/UN���S �/.✓/2 <br />PROPERTY OWNER <br />ELECTRII:AL COtITRACTOR <br />CONTRACTOR' S ADDRESS �O !SO X I�i �C'6 , /�Z�✓ t i�3 � <br />CITY ZIP <br />LICENSE NO. � �J/L�LS/SOLF _ EXPSRATION DATE' <br />ADMINISTR}1TOR �/��� /�PAD3ys)l✓ PHONE NO. Ji �7 ' 3V l� C� <br />VALUE OF WORK {do not include taxes) <br />(for commerical work) <br />USE OF BUILDING �f�N'1�iT/hd.✓�S -- <br />NOTE: WAC 296-46-140 requires that plans for electrical work at educational, <br />institutional or health care facilities be approved by the State of Washington. <br />Applicants with such jobs must show the State approved plans before a City <br />of Everett pesmit will be issued. <br />NOTE: hiring in non dwellings is required to be in conduit. <br />WORK TO BE DQNE: <br />SIGNED: _�{ � �"TJ� DATB• S -o[d-� /� <br />3/27/90 <br />