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CITY OF EVERETT � CATE /O �7 �J � <br /> ELECTRICAL WIRING PERMIT APPLICATION FEE ��� � <br /> JOB ADDRESS . �/�� T�G��-I� AU E <br /> TENANT <br /> PROPERTY OWNER �/N!"i �. J�Ig�TSOC,r <br /> ELECTRICAL COVTRAGTOR O'Gc/ i•/G�/�. <br /> ODNTRACfOR'S ADDRESS - <br /> CITY ZIP <br /> LICENSE NO. EXPIRHTION DAT6 � <br /> ADMINISTRATOA PHONE NO. a f,- � z S"-S— <br /> VALUE OP WORK � (do not include taxes) <br /> (for commerical wo�k) � <br /> � USE OF B�IILDING S/'� <br /> NOTE: WAC 296-46-140 requirey that plans for electrical wo=k at educational, <br /> • inatitutional ar health care facilities be approved by the State of Washington. <br /> Applicants with such jobs must show the State approved plans�before a City <br /> of Everett permit wiil be issued. <br /> NOTE: Wiring in non dwellings is reqvired to be in conduit. <br /> WORK TO �E DONEt <br /> � �(/Fl.�/ /,v��Zl,v6 /N /1DfI�i/0/l/ _, Gc��/lpDr" ;�/ E�'is�l�(// <br /> To Zo� �M�? S��2v�c E . �kE ouT o�v ??,cdC f ,+�oa� <br /> SIGNED: d�Ly1�( /l, /YCLLIdL'G� DATE: �D — / � I I <br /> �� ��� � � <br />