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� � 1....,1 <br /> CITY OF EVERETf DATc: _ ��� �� �7 <br /> ELECTRICAL WIRING PERMIT APPLICATION Fcu �� <br /> II Z� <br /> ,JOB ADCRESS � �t/ �,�2U/� 7Jl.c��9�� <br /> iENANT <br /> PRCPERTY OPlrER �A 7 i O ti�q c., -L/1 U!'S TYy� �!7 T5 ��U�2� <br /> ELECTRICAL CONTRACTOR �� _ /a/ZC ��LCT2 � C, <br /> ELEC. CONTRACTUR'S MAILING ADDRE�� rI� �g - /lo U �- � i. L- <br /> L3CENSE N0. /UOf1/2EC1 /Z50 EXF_RP.'i0N DATE <br /> ADMINISTRATCR (,tJ/!'). [=�',k,Pd Ti-/ PHONE N0. �.3/-�{3 5 y <br /> VALUE OF WORK 5:3 yoo. oo (Co not include taxes) <br /> (for commercia work, <br /> l'Sc GF BUILD::NG �D T[-.-(., <br /> NOTE: WAC 296-a6-140 reauir=s that plans fo: electrical work at educational, <br /> institutienal or health csre facilities be approved by the State of <br /> Washl.ngton. Applicsnts with such jcbs �;.ust show the State-approved plans <br /> befo��e s City of Everett per,rit will be i=sued. <br /> WGRK TO Zc D01�: <br /> t-/�� Y2.r �.rr�� S'c--rzv �e� � Goo �-�P 3 r� <br /> �08 V Gt>;2E ,UEZv � 0 7�L <br /> , , <br /> .// <br /> SIGNED : -- ��„�"���; - DATE ��� — � � <br /> NOTES AND ;OMMENTS: <br /> _:,z <br />