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l°•• <br /> . . � , . / S,' ., , <br /> CITY OF EVERETT DRTE: <br /> ��� ELECTRZCRL WIRING FERMiT APPLZCA'ION FEE: <br /> �az� <br /> s y� �� ,z; " - - �, �' <br /> y z� �oa aocRess �-i ,;�� _ _,_ ; . . <br /> � �� rtr,aNT <br /> "�-7 F`-i"�+'J <br /> H �C FROPERTY OWNESi (�rc.�� - �-- �'��,-'�' <br /> � O C�'1 <br /> o H C [LECTRICAL CONlRACTOR ` ;�� `� C'yc 'ic c � � ;G _ <br /> ~ � LICE'JSE N0. � 'ic G�^"� 5 �dSC� c i/ t�n.t' EXPIRATION DATE � <br /> c�• 0 1. <br /> t-i C �/� - <br /> a HE� fiD�dINISiRATGR eJj� ����1�'1��'rll�C . PHONE N0. i; �� ,`'�- ' ��� �7 � <br /> rHH � - <br /> g � VPLUE OF WORK -1� �� C� C�< (do not include taxes) <br /> H <br /> otym (for ccmmercia work <br /> � �� . � . � � - i.< . . _ . � i�., <br /> z y� USE OF BUILDING /� '- �`='� <br /> H O�n <br /> �'OTE: 'dAC 296-46-140 recuires that plars for electrical work at ecucational, <br /> institutional or health care facilities be acproved by thoroved tplans <br /> '�Vashington. Applicants with such jobs must sncw t`s State-°P. <br /> before a City or Ever�t� pe-�i` will be is:ued. <br /> (�, .,s. <br /> <-. ._3 WORK TO BE DONE: <br /> i,. ��� , <br /> -Y � /-II I(/ � <br /> p� .�A� <br /> � <br /> ,�� <br /> �"_ � <br /> SIGNED : � � , �ATc _ �1 _ "-I� <br /> "� NOTES A�D COP?MENTS: <br /> � 0/10/87 <br /> ty�cN <br />