Laserfiche WebLink
CITY OF EVERETT <br />�ECTRZCAL WIRING PERMIT APFLICATION <br />�- ��_•/ ( /_ <br />DATE: <br />•?� � <br />FEE J`-j .� <br />_ % �C'1� <br />JOB ADDRESS � �' / �� S � �f � ��� — <br />TENi�'!T <br />FROFErtTY OWNR �/ �7 %> l �� �% — <br />t1ECTRICAL COIJ7RACTOR 1��if'�'%)�7�'lJ� (� �C � ����1�� �/���� — <br />LICE��E N0. �,! � �/ > ����F EXPIRATION DATE <br />ADMINISTRATOR T.C�i� � //l %'����%!�_/_� PHONE N0. � �? �I ��%i�— <br />VALUE OF WORK (do not irclude taxes) <br />(for commercia�oik <br />USE OF BUILDING /'Sf"`� �✓�L_i��L� -- <br />NOTE: WAC 296-4E>-140 requires that plans for electrical work at educational, <br />instituticnal or health care facilities be approved by the State of <br />Wa<_hington. Applicants with such jobs must show the State-approved plans <br />before a City uf Everett permit will be issued. <br />WORK TO BE OONE; (� <br />.l�l��X�?GC <br />�r_'�'i %GF <br />SI6�ED : �r/�e (� Z DAiE <br />NOTES AND COMMENTS: <br />6/10/87 <br />192EH <br />