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CITY �F EVRETT <br />DATE: l <br />ELECIRZCAL WIRING FERMIT PPPLICATION <br />• �E: <br />J�B ADORESS <br />�uau7 ��`��� -- <br />FROF-�'Z-TY OWNE� <br />ELECiRICAL CONT�iACTOR <br />LT_CENSE NU. <br />EXP�^�7IGN DAT� <br />ACMINIS iRAT�R �», <br />���i}'� FH�NE N0. �3i4.����aZti <br />VALUE OF WORK u/� ?5����- (do not include taxes) <br />(for commercia wor�cl <br />USE OF 6UILDING l� �� 7�j�p� <br />NOTE: WAC 296-4�-140 reGuires that plans for electrical wotk atthe LStatenaof <br />instituticmal or health c�re facili'ties be apprcved by <br />Washingtor�. Applic>nts with such jobs must show the State-approved plans <br />before a City oT Everett pe^nit will be issued. <br />WORK TO 8E OONE: <br />�// �'lee�e� <br />/�f oa� <Y_g g <br />SIGNED • � / ' i' ---- <br />MOTES A OMMEN75: <br />6/10/87 <br />1322H <br />