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tx � � <br />C=1 <br />p <br />�H�n <br />��� <br />� <br />��� <br />y <br />�O <br />�HC <br />��g <br />��• o <br />�� <br />Cy <br />HH <br />g� <br />�d� <br />��[� <br />Hoy <br />�+�1 IBa�i <br />crrY or• 6VfiRETT DA7�e s > Ci I <br />ELECTRICAL WIRZNG PERMIT APPLICI�TION FEE �S I-� <br />JOB ]�DDRESS � �/ v (� �/ � U-N L I� � � �/ 1� � <br />TtiN71NT <br />PRf1PfiRTY OS9t7ER �'\ �i 7•( an� v�Z � I <br />PLEC'fR1Cni. C'ONTRIICTOR W �%JD �C�IZ p C- �� 11�L � C <br />CONTMCTOR' S 7�DDI2E55 �� �f JJ � �� S� /� tJ'1 1 S1 � z_J I <br />CITY ZIP <br />LIC6NSE NO. � C?��%rK-� l�-� � L� EXPTRI�TION DnTE � <br />nDMINIS'Pf2/�TOR Jv ��� W� J� � Su`� PIIONG N0. 2� Z- �S % U� <br />VALUE OF WORK (do noC includc taxes) <br />(for commerical work) <br />USE OP BUILDING %��F � ��Z � 5 <br />�-�` NOTE: WnC 296-4G-140 requires thaC plans ior electrical work at educational, <br />�C � institutional or health care facilities Ue approved by the State of Washington. <br />� i npplicants with such jobs must show the State approved plans before a City <br />i <br />__� <br />of EveretC permiC will be issued. <br />1 � NOTE: Wiring in non dwellin9s is required Co be in conduit. <br />�� ' <br />wotttc �ro as �oNs: <br />I�� � I Q� AJ: —�J l'V� ,l 5 � 2 u� J-�.� �. <br />� <br />SIGNCD: <br />3/27/90 <br />DATG: � � 5 / 1 / <br />�.. .�.LD �...:,�.�.. .'��.� ..,.._.. , ..�..C�¢4f��a�:�•:Sl.�. ,.. . .r..,....�"r�T:lr..� ... . , , . -.pi . <br />n <br />{ <br />Q <br />a <br />