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CITY OF EVERETT DATE �G'�7��j( .� <br /> ELECTRZCAL WIAZNG PERh1IT APPLICA7ION FEE � •;�'� -`- _ <br /> JOB ,�o�ss �� i 7 %��.���1�;-, _ <br /> x�'i1 TENANT /.4 � � <br /> [�f9H ( <br /> C%�H PROPERTY OWNGR S � i�q.-Q <br /> � �`� �¢ �F F/ �" . <br /> ELECTRZCAL WNTRACTOR �¢ C l' <br /> '� y .�ro CONTRACTOR'S I�DDRESS //JrG � �� Sj.l�r �sT✓�i�s ���55- <br /> O�H� CITY ZIP <br /> V1 H <br /> x Z� LICENSE N0. ��F��I SO I. G� EXPZRATION DATE _,/��//`��_ <br /> [�) O � /-� <br /> y � y7 . PHONE NO. ����1 //S / <br /> � H ADMINISTRATOR c` j+ /2://�I � <br /> H �8 <br /> 4�� n (do not include taxes) <br /> H <br /> VALUE OF WORK <br /> z y (for commerical work) <br /> ty N H USE OF PUILDING =J!/7�fH' !-�'fU>//4 - <br /> c�7C7� � <br /> C�� � NOTE: WAC 296-40-140 requires that plans for electrical work at educational, <br /> �j institutional or health care facilities be approved by the State of Washington. <br /> y � � Apolicants with such jobs must show the State appzoved plans before a City <br /> of Everett permit will be issued. <br /> ��� NOTL: cairing in non dwellings is reqvired to he in conduiC. <br /> '� � WOR}: TO 0E DONE: ' <br /> � <br /> � �� '��n �z.�� ����✓� � ..v � �y�r� .3 �r� k.- < <��•��T <br /> �_� <br /> �I ��� <br /> ��� <br /> ��—� SIGNED: :-r l{/.�f -�=-!^v� _ DATE: �O�y /?/ <br /> � <br /> I <br /> � �� <br /> � <br /> 3/27/90 <br />