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. <br />CITY OF EVERETT <br />ELECIRICAL WIRING PE}iMIT FWPLICATION <br />JOB ADCRE55 <br />TENANT <br />PRCP�TY OWPER <br />ELECTRICAL CONTRACTOR <br />_, <br />DATc• �I- I,� ��l <br />Fc'c: <br />�U � �,. / 0 11 i9 ; S <br />,S�iYI � <br />ELEC. CONTRACTOR'S MAILiNG ADDRE�fi �%] 3:y j�,� �4' � y�� � <br />LICENSE N0. C��7NS�PL /S 3��� EXF_TRA.?i0N DATE 9/ <br />ADMINISTRAT�2 /� �% '� <br />,SC�Ni,� �Yi�PI � PHONE N0. 7 3��- �{15��J <br />VALUE OF WORK (Go not include taxes) <br />(for commercia work <br />USc CF BUILDING <br />NOTE: WAC 296-a6-140 reauires that plans fo: electrical work at educational, <br />institutional or health care facilities be approveC by the State of <br />Washinaton. Applicants with such jobs �;.ust show the State-approved plans <br />before a City of Everett permit will be =ssued. <br />'80RK TO Ec DONE: <br />�% / �� <br />SIGNED : // / ��G �-� �i DATE � �� � _ ,�� j <br />�� <br />NCicS AND COMMENTS: <br />