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CITY OF EVERETT DATE ., l'� O <br /> x .�L'a <br /> [q a y ELECTRICAL WIRING PERh1IT APPLICATION FEE L,�J � <br /> ��H ,r� / <br /> H�� JOB ADDRESS ..C. 7 G� 1 � �li I` � <br /> K y� TENl\NT � ` /�1% ��D�r� <br /> O �� PROPERTY 047NER . SC -P <br /> (i) y� GLECTRICAL CONTRACTOR �'�� ,C /� G� / I C <br /> � ��7 CONTRACTOR'S ADDRESS ��)G}�/ .�G /�, ' )/ /-- � -� <<�Ph'S ������-3 <br /> �� � ^ITY ZIP <br /> � H� LICENSE N0. ,�G �/�,�� C' � C� EXPI.RATION DATE ,�. .�//S'/ <br /> HH y-� �-7 /7 <br /> g ��H F�D[4INISTRIITOR �i�h, /;�'rylt/^ PHONE N0. _� J �� � ���� / <br /> C� ❑C7� <br /> � (z�r VALUE OF I40RK (do not include taxes) <br /> y� (for commerical work) <br /> HOm � /, � �/✓ <br /> � USE OF BUIL�ING , � .-- <br /> � <br /> NOTE: WAC 296-4(i-140 requires that plans or electrical work at educational, <br /> institutiona]. 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 peimit will be issued. <br /> � � <br /> ���+: NOTG: Wiring in non dwellings is required to bc in conduit. � <br /> .� <br /> �,z � WORFC TO BE DONE: <br /> r �/ O CGrt�J�� -'i c --r _— <br /> '� w <br /> �� — <br /> k"�`�"'a <br /> i <br /> �. <br /> l �� <br /> �'�S� SZGNED: � � � /�lt����' � vr DATE: �L� o� J � <br /> �. <br /> 3/2�/90 <br /> � <br />