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(` G� <br /> ` 1)111Fi �� - d - � <br /> CITY OF EVERETT — <br /> ELECTRICAL WIRING PERMIT AFPLICATION s'EE ,� 5��� <br /> JOB �o�ss _�� r a � i�'���.� ��� ; �.�- <br /> � <br /> TENANT j <br /> PROPERTY OWNER �- ' 1��' � S�'�- / <br /> ELECTRICAL CONTRACTOR l� i-ia� s•�� �/�f'c ' "/�� c.. <br /> CONTRACTOR'S dDDRESS ��Ci�L� J ����� � �" �'r � <br /> CITY ZIP <br /> LICENSE N0. ��r S Sc�I .5,j }L �C. EXPZRATION DATE �_(1�n�S �� ' <br /> ADMZNISTRATOR �� / L ��r-�5 �� PHONE NO. '1�7�' �-�S � — <br /> VALUE OF wOAK (do not include taxesl <br /> (for commerical work) / <br /> USE OF BUILDINGs�C�S� �C� v!F% <br /> NOTE: caF�C 296-46-140 reguires that plans for electrical work at educational, <br /> institutional or nealth care facilities be approved Ly the State of Washinqton. <br /> Apl:licants with such jobs must show the State approved plans before a City <br /> of Lverett permit will be issued. <br /> NOTE: Wiring in non dwellings is required to be in conduit. <br /> WORK TO '�E DONE: - <br /> �c T ,� D � /3�� S�r�--v.� .,v <br /> ���' �L �G LU"��""'v" DATE: /� / " %�L? <br /> SiGNED: t — <br /> 3/27/9G <br />