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CITY OF EVERETT � � DATE I^ I C� - � � <br /> ELECTRSCAL WIRING PERMIT APPLICATION FEE ��,J o0 <br /> �/� / <br /> JOB ADDRESS '%�� lM iQ C�.h!�I � � - <br /> TENANT <br /> PROPEATY OWNER /y 1 NO✓"�-� C� ��ST <br /> ELECTAICAL CONTRACfOR J-� {a V�Q c.J <br /> CONTRACTOR'S ADDRES S / S� I Z vti; l t � c.c c it 31 vd v�-�;1�c r-��r� °f B"o I'Z <br /> CITY ZIP <br /> LICENSE N0. SQ.A�!� -C j)p) K C EXP::RATION DATE % S - � � � Z <br /> ADMINISTRATOR �e.$S-�����/4 G PHONE NO. ��J�" o�S a � � <br /> � VALUE OF WORK (do not include taxes) <br /> (for commerical work) <br /> USE OF BUILDING S • I- • IZ <br /> NOTE: WAC 296-96-140 requires that plans for electrical work at educational, <br /> institutional or health care facilities be approved by the State of Washington. <br /> Applicants with such jobs must show the State approved plans before a City <br /> of Everett permit will t�e issued. <br /> NOTE: Wiring in non dwellings is required to be in conduit. <br /> WORK TO BE DONE: <br /> S - �=- � - 21J0/� <br /> ,. <br /> , <br /> , <br /> ; <br /> ' SIG . �-4-JjJ�✓� DATE• / _ /�- � I <br /> ' ( <br /> s 3/27/90 <br />