Laserfiche WebLink
CI'iY OF EVERETT DATE: � �O gCI — <br /> ELECTRICAL WIRING PERMIT APPLICATION FEE: ��� , <br /> JOB ADDRESS Z (� 2 ` IC�t{(C£^� /A�N�T `� • _ <br /> TENFINT _. � <br /> PR�ERTY OWNER � � gC�'R'� S/1�J4�� • <br /> ELECTRICAL CONTRACTOR <br /> ELEC. CONTRACTOR'S MAILING ADDRESS <br /> LICENSE N0. E�IRATION DATE <br /> ADMINISTRATCR P�� �• <br /> VALUE OF WORK (do not include taxes) <br /> (for commercis wor <br /> USE OF BUILDING � �� a' ���• <br /> NOTE: WAC 296-4ci-140 requires that plans for electrical work at educatio�al, <br /> institutional or heaith care �aciliti�s be approved by the State of <br /> Washinaton. Applicants wi�h ,uch jobs must show the State-appraved plans <br /> before a City of Everett permit will be issued. <br /> WOR�( TO BE DONE: <br /> Rfl D ""`�' i`C'.-cC.'f'� �I� � C�kTLC—TS . <br /> � ��.J��.N ---- <br /> 1 L � � �-1 T o Kr t..�-r <br /> SIGNED : (�(i(��� ��✓�l---- DATE � 3 � S <br /> NGiES AND COMMENTS: <br />