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�i <br />CITY OF EVERETT <br />CLECTRLCAL WIItING PESiMIT nPPLIC�TION <br />�oo rwoness 20I � i� � e� I�1 � R F�v� <br />zrri�r \ n.� ,�l�i k i a S <br />PROPERTY OWNER � �`� V1u`C� � S <br />ELECTRICAL CONTRAGTOR CS LtJ .J E��z <br />CONTR7ICTOR' S nDDIiE55 <br />LLCENSE NO. <br />RDMINISTRTTOA <br />� <br />DATE ID ��J_�' � � <br />FEE ��` <br />TY <br />6XPLIV�1'ION D�TE � <br />CIIONE t70. f ���� - �3> > C <br />Z2P <br />VALUC OF WOFtK (do not include taxes) <br />(Eor commcrical work) <br />USE OF �UILDING l�� S�� <br />NOTE: WnC 296-46-140 requires t1iaC Plans Cor elecl•cical wock al• educational� <br />institutional or health cate f:acilities be nppzoved by the State of Washington. <br />npplicanta witl� sucl� jobs must sliow tlie State appcoved plans Uefore a City <br />of Everett permit will Ue issued. <br />t70TE= Wlring in non dwellings is Lr_qui.Ted to be in con�uit. <br />WO[iK TO DE DONEi <br />S�e�^u1c�. <br />SIGtIGD: _ � � <br />4t��� 1a�' <br />/�" ��- y� <br />DAT6t � <br />. . _ _ . ........ ..�...�........�....,. ,......a..�wv.»._.... <br />