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CITY OF E`/ERETT ^ OATE: � -�� � � <br /> ELEC7RIC.9L WIRL�G PERMIT APPLSCATION �= <br /> JOB ACORE55 � /t � ' �-�"tii � <br /> TENANT <br /> FROPERTY OWNE� l/ /� /f�✓ldn/ <br /> / i i <br /> ELEC7RICAL CONTRACTOR �`i�'S��N �/Pc'�� <br /> LTC�P15� i!0. �UfH �S�S�!J�fZ E:<P?.4ATICN OATc �� /�O <br /> FCMINISiRATOR �'H- �L�'I���✓ FHONE N0. ���/ ' 3-�J/ <br /> VALUE OF Y!GRK (do not include taxes) <br /> (for ccmmercial workl <br /> USE OF BUILDING /Z? �5!��C'r�/C Q� <br /> NOTc: WAC 2°6-46-140 requir=s that plans for electrical work at educational, � <br /> institutional or health car= Pac;Lties be approved by the State oP <br /> Vlashirgton. Aoolicants wit!� such j�bs must show the State-:.�nroved plans <br /> berors a City of Eve:ec't pe=-nit wi11 be issued. <br /> 'NORK TO BE DONE: <br /> � UU /�i'�-�-',� /��/ .SLI-�!'✓•�c •� _ <br /> SIG�;E� : �?'vV ��/I/G�'�^-�• DATc 7-//-b�% <br /> riar�� �aro cc>��.+F•irs: <br /> �i:ci3� <br /> ir��,1 <br />