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� <br />CITY OF EVERET'f <br />FIECTRIC.aL WIRING PF3tMIT APPLICATION <br />JGB ACCRE55 <br />TFr�ANT <br />RiOF�TY OWNR <br />� <br />oarE: <Z�' 3 ° �� <br />2 �v <br />FEc; S '— <br />P �J l.0 �" <br />('ro.t��,- C✓s7� �Mfs <br />ELEC?RICAL CON7RACTOR ^ <br />� ��,-y �-��znz�� <br />LIC�`15c No. .�NT��zeTYPZ 2Z EXP�A7ZCN DAT� � gp <br />ACNINI57RATCn � � I( �-�o y r� FHaNE N0. 3�3 °/-- �-9 3 y <br />VALUE OF iVORK (do not include taxes) <br />(for cce �ercial workl <br />USE OF BUILDING T L��l/� � G(� yv 5( S�(Z(J / C L-� <br />NOTE: WAC 296-46-140 requires that plans for electrical work at educational,�� <br />institutional or health car= facilities be aoproved by the State of <br />Washirgton. Apolicants with such jcbs must show the State-aoproved plans <br />bePore a City or Eve:=tt pernit will be issued. <br />WORK TO BE �ONE: <br />N �� S �= �Z <br />SIGJED : ���� ��G� DA i c r 3�/� <br />P10Tc� Pi�D CC`�MElTS: <br />^i i�/:i <br />1: �au <br />