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CITY OF EVERETT <br />� F` Y• DATE S' � I- � I <br />ELECTRICAL WIRING PERMIT APPLICATION FEE_���0 <br />JOB ,�D�ss Cnh ly L�e�wt�e A�E <br />TENANT <br />PROPERTY OWNER K�V� I�'� CW I I I S�C'Q <br />ELECTRICAL CONTRACfOR <br />CONTRACTOR'S ADDRESS <br />LICENSE N0. �� ��� la I�1�_ <br />ADMINISTRATOR F�FiT Ac�amS <br />VALUE OF WORK <br />(for commerical work) <br />USE OF BUILDING _ 1`PC1�@V�C� <br />gXpZRAT20N DATE � �' � I' 1 oi <br />PHONE NO. �3 1' c!� 1 I <br />(do not include taxes) <br />NOTE: WAC 296-46-140 requires that plans for electrical wo-k at educational, <br />institutional or health care facilities be approved i,y the State of Washington. <br />Applicanta with such jobs must show the State approved plans before a City <br />of Everett permit will be issued. <br />NOTE: Wiring in non dwellings is required to be in conduit. <br />WORIC TO BE DONE: <br />SIGNED: �� �J(� "M'v'i" <br />3/27/90 <br />DATE: S' d�' 7 � <br />