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CITY OF EVEAETT ( � CA'LE ' I/ C1 <br /> ELLCTRICAL WIRIHG PERNST APPLICATION FEE� <br /> SOB A➢�RESS I�I/I o'3S�/'� <br /> TEM7IIJT <br /> �— r <br /> ?FOPEA2Y CWNER ��JMq ( _ <br /> tiLECTRICAL CONTRACiOR D[U'nl 9.� <br /> CONTRACTOR'S hDDRESS ��i4� <br /> CITY ZIP <br /> LICENSE N0. _ ^ E%PSRhTION DATE _ <br /> ADMINISTRIITOR FfiONE N0. ,7�J —�Z�_ <br /> VALUE OF WORIC (do not include taxes) <br /> (foz commerical Mork) <br /> USE UP BUILDING ��Fw[T/A}- _ <br /> NOTE: WAC ?96-4G-140 requires that plans for electrical work at educational, <br /> i.nstitu[ional or health care facilities Ce approved by tF.e State of Washington. <br /> lpplicants with such joFs must shc•.0 Yhe SGate approved pians before a Ci^.y <br /> of Everett pexmit will he issued. <br /> NOTE: wiring in non dwcllings is cequirc3 ta bc in conduit. <br /> WOR}: TO PE DONE: <br /> �,4.UJGR'T`L /��£Ti R _ <br /> i . <br /> 1 �-fJt7 Li�uiTS _ <br /> SIGNE�: � f�� _ DATE: ��'�Jn <br /> 3/27,/^0 <br />