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� „ cr. t or t:ver-.cr.r �:;,1r. 7 � ('(/ <br /> � d� <br /> ro / 1 cJ <br /> q C E.LF.CTRSGIL WIRING PERt�fIT FIPPLIGITION FEE�j, <br /> 4 � <br /> N <br /> t I <br /> y � ��� � � �'� f'�� 1%�1 � 7`� = —JSl2 <br /> K � .;uu ��oottEss � �1Z4 J{ � �cti1 � <br /> o � o .. <br /> "° �, � z�;��,r l)�>�<<� (���1 r �1,���1 t��s <br /> � _p � <br /> W H � PROPEATY OWNcft � �' "' � „ � �I�vV E <br /> O �+ ` <br /> n � �q ELECTRICAL CONTMCTOR J�L1Vl-OI� � �AIL ' <br /> Z y i R f' (�p <br /> � H � C(:tiTFACTOR'S ADDP.ESS I ( �l I S� I Z� ( LC �5,iR.1/ /.IV��� -11����/ <br /> y ���ITY ZIP <br /> � F � LICEtISE HO. �7 / ���L(JS. � �U�J� E4PIR1TIOi1 DATE 'T ���-1 l�• . . <br /> � �' i ���,j�( PHONE N0. �i "� 1 I Z�J <br /> TC�fINISTR120R r'�'�'r�f <br /> VA[.UE OF WORK '11 rj�J •��U (do not include taxes) <br /> (for commerical wozk) <br /> � u5E OF BUILDING ��L� T�A ITi I�<1 ��CA,�LL�� __ <br /> ;�OTE: HAC 296-46-140 =equizes tha p1Ans for elect:ical wozk at educatianal, <br /> institutional or health care facilities he approved by the State of Washington. <br /> Applican[s with sueh jobs must show the State approved plan, 6efore a Cit7 <br /> of Everett permit vill be issued. . <br /> ,�� t70TE: Wizinq in non dwellings is required to he in conduit. <br /> � '�;ORlC TO BE DONE: <br /> �-- l l5' ��,, .�r� a �s�.v�.<s���•» ��o �,��,� <br /> �i' <br /> I' ` <br /> �w <br /> 's' / ' �� � /. �. <br /> � : i �� /� W1TE: / ... <br /> SIGf7ED: %��:�;� ��, . -.�.�:� � <br /> , '`� / <br /> ��� <br /> �1 � <br /> J/Z%/?o <br />