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CITY OF EVERETT DATE: 5-7 <br />ELECTRICAL WIRING PERMIT APPLICATION FEE: <br />JOB AJDFESS 14C4/YIait." Oe' �v/1L PL <br />TENANT �,_6L L <br />PROPERTY O'INER _E_ <br />ELECTRICAL CONTRACTOR 't- (/ H ( C1_�-'-iC <br />LICENSE NO. W L ( e22 EXPIRATION DATE <br />ADMINISTRATOR PHONE NO. <br />VALUE OF WORK (do not include taxes) <br />(for commercial work <br />USE OF BUILDING <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 <br />Washington. Applicants with such jobs must show the State -approved plans <br />before a City of Everett permit will be issued. <br />WORK TO BE DONE. <br />SIGNEO : ag <br />�F�i1CQ2 G� DATE <br />NOTES AND' COMMENTS: <br />6110181 <br />1928H <br />