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CITY OF EVMETT <br />ELECTRICAL WIRING PERMIT APPLICATION <br />DATE: s: / it r,1 !� y <br />FEE: <br />JOB ADDRESS <br />TENANT <br />PROPERTY OWNER <br />ELECTRICAL CONTRP <br />LICENSE NO. <br />EXPIRATION DATE <br />ADMINISTRATOR PHONE NO. <br />n <br />VALUE OF WORK 2 S G� (do not include taxes) <br />(for commercia work <br />USE OF BUILDING % G <br />NOTE: WAC 296-46-140 requires that plans for electrical work at educational, <br />institutional or health care facilities be approved by the .State of <br />Washington. Applicants with such jobs must show the State -approved Flans <br />before a City of Everett permit will be issued. <br />WORK TO BE DONE: <br />zl� <br />SIGNED /�� i / �n / DATE <br />NOTES AND COMMENTS <br />6110187 <br />192EH <br />