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I � <br /> �.�.r�:� ' . <br /> � I ; � <br /> � <br /> u �� �. .`. <br /> CITY OF EVERETT <br /> DATE �� �/5O_ <br /> ELECTRICAL WIRING FERMIT APPLZCATION FEE �G ! <br /> � � JOB ADDRESS /I�-�G/�GN # U��=S� /l�iH/LiF/l- //�Fiv U/I�d�- � <br /> q'"� TENANT CiT`1 D6 �✓r,P�fT — �if11/ts �S"�l� - LF6/en//�4*-c� <br /> s <br /> H1' � PROPEATY OWNER C I T'�I QF �✓�. F"�— <br /> N <br /> � ELECTRICAL CONTRACTOR �I(I�"�'�� �N'��� �`���f• �'�L ) <br /> � y� CONTRACTO[i'S ADDRESS �5�� �� � /��"6 ��� I���� <br /> � � CITY ZIP <br /> ' �� LICENSE N0. C�y �(1�"L/SS�L�/�� E:SPIRATION DATE . 7 2� �' Z � <br /> p� ADMINISTRATOR L(��d/�E� /��f/ PHONE NO. 7�� � Z��� ' � <br /> � y VALUE OF WORK � �.Jc'O (do not include taxes) <br /> ~N N (for commerical work) <br /> �y �A�/�'.��/4 f��cc.- _ <br /> USE OF BUILI:iNG <br /> �� NuTE: WAC 296-46-140 requirea �`het plane for electrical work at educational, <br /> institutional or health csre facilitiee be approved by the Stnte of P7ashington. <br /> Applicante with such jobe must ehow the 5tate approved plana hefo:e a City <br /> of Everett permit will be issued. , <br /> � NOTE: Wiring in non dwellings ia required to be in conduit. , <br /> '� �' i <br /> �� WORK TO BE DONEt <br /> /=/,2E �t�� -SYSY�n7 — �� Q/1.�I �pT', ZS`l--d3DD <br /> �� = , <br /> f0 Bini F�/f��/ <br /> i <br /> 1 "j ; <br /> � <br /> � ' ' /J �j7 C <br /> _ _ <br /> �-I� SIGNED� ��( /Y �/��� �— DATE: /�� / � <br /> ��� <br /> . � <br /> 3/27/90 <br /> � ' <br /> t <br />