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CITY OF EVERETT <br />ELECTRICAL WIRING PERMIT APPLICATION <br />DATE: <br />FEE: <br />JOB ADDRESS I9h V t ST' , b l/EVC 7y <br />TENANT <br />PROPERTY OWNER I2,f 5 <br />ELECTRICAL CONTRACTOR Acme j9 ewe✓ <br />LICENSE NO. EXPIRATION DATE <br />ADMINISTRATOR PHONE NO. <br />VALUE OF WCRK (do not include taxes) <br />(for commerc al worK <br />USE OF BUILDING <br />NOTE: WAC 296-46-140 requires that plans for electrical work at educational, <br />institutional or health care facilities be approved by the .State of <br />Washington. Applicants with such jobs must show the State —approved plans <br />before a City of Everett permit will be issur,d. <br />WORK TO BE DONE: <br />SIG,14ED : <br />6110187 <br />192EH <br />