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H O H <br />/ � , <br />[+1 H <br />CITY OF EVERETT <br />DATE <br />H y <br />ELECTRICAL WIRING PERMIT APPLICATION <br />�o <br />FEE J S <br />k 0 <br />JOB ADDRESS <br />H <br />"OO H H <br />TENANT )/ll ii <br />FA <br />V.#,) <br />x <br />[a7 p �s7 <br />PROPERTY OWNER _ 5 �Q/�y) <br />�. <br />O H <br />H 0 g <br />ELECTRICAL CONTRACTOR <br />G7 • C] <br />CONTRACTOR'S ADDRESS <br />/ / <br />7 U 1 <br />/1 � <br />LC1 �G y �l/Y.li'�� <br />/1 p <br />"),4 9Q�-O <br />C y <br />.� <br />CITY ZIP <br />�yHH <br />O ti H <br />LICENSE NO. <br />EXPIRATION DATE' <br />0�+ to <br />�ty+ <br />T. Cs1 t" <br />ADMINISTRATOR <br />PHONE NO. <br />' .$7- 2/ 7 <br />H O to <br />VALUE OF WORK <br />(do not include taxes) <br />(for commerical work). <br />USE OF BUILDING _ hernj <br />NOTE: WAC 296-46-140 requires <br />that plans for <br />electrical work <br />at educational, <br />._ <br />institutional or health <br />care facilities <br />be approved by <br />the State of Washington. <br />` <br />ApplicantW with such jobs <br />must show <br />the State approved <br />plans before a City <br />of Everett permit will <br />be issued. <br />NOTEt Wiring in non dwellings <br />is required <br />to be in conduit. <br />WORK TO BE DONE: <br />SIGNED: _ j DATE: �(�-/�- ci <br />