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CZTY OF EVERETT DAT� v I L� /`r0 <br /> —f---- <br /> ELECTRIGL WIRING PERM2T APPLIGTION FEE � Sc, <br /> JOS ADDRESS _� Cl ?L1 L" � ,�`�I�f,�• i � \� <br /> TENANT <br /> PROPERTY OWNER � ��C.I.�C .V 1����-^�(-�`,?�,C' tiJ <br /> FT.F.CTRT.CAL CONTRACTOR u�-ti IJC\ � . <br /> CONTAACTOC.'S A_�DRE55 <br /> . � � CZTY ZIP <br /> LICENSE N0. _ _ EXPTRATION DATE <br /> ADMINIETRATOA , . PHONE NC�. rj� J G s ? ? • <br /> VALUE CF WORK __ (do nut incluce taxes) <br /> (fcr coa�ezical .mrk) <br /> USF. OF BUILDING _ [`(� � �;'�,_ti �� (_ _��/<: <br /> NOTE: WAC 296-46-140 requires that Flans for electrical work at educational, <br /> inetitutioral or health care _'ac=llties be anproved by r=e State of Washinqton. <br /> Appli�ants with such jobs must shoa the Sta=e aporoved :71ans before a City <br /> of Eneratt permit will be issued. <br /> NOTE: Wiring in non dwellinqs is required to be '.� conduit. <br /> WORK TO Bc DONE: <br /> /�'� ��.i /�-,i--\� `�C-��L' , �' </ <br /> SIGNED: � \ .h,i,y� DATE� L �I L' <br /> �_�f,� <br /> 3/27/90 <br />