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.�y � � �� � <br /> �., ciTv oF �Err . oa�: �� <br /> ELECTRICAL WIRING PERMIT APPLtCATION FEE: <br /> ia <br /> JOB A�ORESS D��.� � ,_(QJq�-t �U� lQ �� <br /> TENANT - . . l l�(C7 !:�l�I <br /> PROPERTY OWNER <br /> . � <br /> � ELECTRICAL CONiRACTOR iue ~ C, `' <br /> ' LICENSE N0. O � EXPIRATION DATE �'�g(� <br /> ':� <br /> AOMINI57RATOR � PHONE N0. ZJ`/�o�o � � . <br /> .' VALUE OF WORK �j�'y'1� �do not include taxes) <br /> '; (for commerciZ work'� . <br /> USE OF BUILDING ��l h(��'y}(,�(/����, ' ) <br /> NOTE: WAC 296-�:6-140 requires that plans for electrical work at educaticnal, <br /> institutional or health care facilities be approved by the .State of <br /> iVashington. Applicants with such jobs must shox the State-approved plans <br /> before a City of Everett permit will be issued. <br /> r� <br /> WORK TO 6E DONE: � � <br /> � <br /> i � � .� <br /> ; — /;� /► �- I <br /> L/ /CO H 1�- �L�.e �t 5 Go►1r1ec.T <br /> � • <br /> � <br /> : <br /> SIGNED : DATE <br /> NOTES AND COMMENTS: ' . <br /> � <br /> � � <br /> 6/10/87 <br /> ; 1928H <br />