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� i <br /> � ` : � <br /> , � <br /> � <br /> CITY OF EVERETT � �ATE `J <br /> � <br /> �`"d ELECTRICAI, WIRING PERMIT APPLICATION <br /> FEE � ,�� <br /> $ 7 (; /^ '� '/q <br /> JOB ADDRE55 �" I� �J __�� ���ii.r � /. 1wL • � ,�SS—��.T / , <br /> TENANT �� J i� � \ T �J�/4A��LC,tI! I, <br /> yx � PROPERTY OWNER �r � „ � ��v V�' '� � <br /> t9�y T <br /> p p7x ELECTRICAL CONTRACTOR � �- y � � , <br /> r�� CONTRACTOR'S ADDAESS I l� I S 1 Z.�- T�k A�1�G (�Y � '"��� �=�3� <br /> � H� ' LICENSE NO. . S I.LIL�LC�� .� ����� � EXPTRATION DATE 'l I �I� ,~�i'� I - <br /> y �~ ADMINISTRATOR R<="rk-. AJ�Sc7N - PHONE NO. . �i�J 1'� I�c7 i, <br /> � ��.. � � �-y '� <br /> p H d , VALUE OF WORK � ! �J ��� (do not include taxes) � <br /> � �g (for commerical work) �. <br /> y�Y C) � . <br /> � � A�E�Li �IJG� <br /> �n�� _ _i , -n n_. �t <br /> Y y� ; USE OF BUILDING rit�7ll IJ! �v � � �l ' <br /> y i <br /> r y H � NOTE: WAC 296�46-140 requires that plans for electrical work at educational, - <br /> gi..i ' institutional or health care facilities be approved by the State of Washington. <br /> n a y Applicants with such jobs must show the State approved plans bef'o're a City <br /> �t�f�" � of Everett permit will be issued. i <br /> �y � NOTE: Wiring in non dwel lings is requ i r e d t o b e i n c onduit. �� <br /> I <br /> . WOAK TO BE DONE: I . <br /> � �`J' �- ��C,� .Y/7iJ.�O (9�l'LI�rC.I�-5/ ' O C lt� <br /> i � <br /> / I <br /> �� <br /> ' ' <br /> �- <br /> � _ �� I <br /> ! ' <br /> DATE: <br /> SIGNED: <br /> �;"i � <br /> i� � � <br /> _! <br /> 3/27/90 <br /> � '� <br /> � � ��� � <br /> � <br /> �� <br /> i <br /> . . .. . . . . . . . . .. . I� <br /> � <br />