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a <br />Hx <br />1.4 0 <br />x <br />H <br />x <br />8d <br />0H <br />Nag <br />Q. 0 <br />t H <br />HH <br />�Oy y hl <br />0 qCq UA <br />LT1 C <br />tl1 <br />H 0 rAA <br />CIJ <br />Q"W <br />.3 <br />CITY OF EVERE1 i DATE: <br />—Y� <br />ELECTRICAL WIRING PERMIT AFF —CATION <br />FEE: <br />XB ADDRESS <br />TENANT <br />4 PROPERTY OWNER _L ,t) n / 1 (Lwu0`& <br />ELECTRICAL CONTRACTOR <br />ELEC. CONTRACTOR'S MAILING ADDRES <br />LICENSE NO. Tel'7-FAgg;-T4_ pa E)PI.4ATiON DATE <br />ADMINISTRATOR 9 C d1 PFME NO. <br />VALL- OF WORK S��Q . d 0 <br />worx <br />(do not include taxes) <br />(.'or commercia <br />USE OF BUILDING <br />NOTE: WAC 296-46-140 reeU±res that plans for elect_cal work at educational. <br />Washington. Or health care faac' {ties be approve_ by the State of <br />Washington. Aepli+cants with such jobs cost show the State -approved plans <br />before a City of Everett pe_.*t will be issued. <br />WORK TO BE DONE: <br />Ll <br />DATE <br />NOTES AND CCWENTS: <br />A <br />