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�azc j' / � 'i / <br /> CITY OF EVERETT • � �.= <br /> FEE 7 � <br /> GLECTRICAL WZRZNG PER?1IT 71PPLICATION <br /> .y,..�-ni.~ij JOB ADDRESS (/ 7� C 7� / J / I/ fC � �"�. _ — <br /> �>�-3 l l '� <br /> r9;tl S TENANT � /'� ' ��� <br /> C H <br /> 9�-3 V� <br /> H 9 3 PFOPERTY OWNER �.J� -i � <br /> y yH � � � i <br /> ELECTRICAL CONTRACTOR � � � � �/ � ` <br /> � H� . <br /> __,�,�, _ '�_ , 5�1r���_,� .-�! <br /> yf~/�C COIITRI�CTOR'S ADDRESS � . CITY ZIp <br /> z <br /> � yd ' / � -% 2 <br /> U• ��y EXPIRATION DnTE I'I l <br /> � ��y LZCENSE N0. _�Jt ))1 IC�ICI <br /> H 1T10 �' '��� .C,, PHONE N0. �i �� �� � �/ ���' <br /> 47• O e1Di1ZNISTRITOR � t:U <br /> VALUE OF WORY. ✓ <br /> (do not include taxes) <br /> r �+'-7 (for commerical work) <br /> �y ti <br /> O H - ,; '� <br /> n d y USE OF BUILDING �� � I� <br /> � �M <br /> z Ht/� NOTE: WAC 296-4G-140 requires [hat plans fnr electrical work a[ educational, <br /> '� o y institutional or healtl� caze facilities be approved by the State of Saashington. <br /> ,�pplicants with auch jobs must show the State approved plans be:ore a City <br /> of Everett permit will he issued. <br /> ❑C?'1;: t4iring in nen d�..elli.ngs i:; rrn�i'�ed '=^ h� in condui`. , <br /> "'`� WOR}: TO ➢6 DOI7E: <br /> � � <br /> � ` �' ' <br /> �� <br /> s+ <br /> '�� <br /> a' <br /> �!� <br /> ��� . 1 . i � <br /> /•{ �1 i • _ DATL: ( _ <br /> SIGNED: ��� :��� � -- <br /> 1� <br /> +.. � <br /> �'� <br /> 3/��7/7D <br /> -... . ..�o....r.. , . ,. <br /> .-..... , �_.�.... ..... : .� ..,_,,, . <br /> .-.�..... ... . ......,.__..�. <br /> � <br />