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CITY OF EVhRETT � DATE: G� �� h l <br /> ELECTRICAL WIRING PERMIT APPLICATION FEE: ��� '� <br /> JOB ADDRESS ,� �/G' �j SIrU`�I �9k�c � C:i�.nE j1- <br /> iENANT �Dv� l . f-.�c,l� <br /> PfiOPERTY OWNER J���y LL�y-.Sd.J <br /> ELECTRICAL CONiRACTOR ��_���t.aq L��v �(1' ���; t <br /> LICENSE N0. EXPTRATION DATE <br /> ADMINISTRATOR � 1;���,., �r,.,'�r�•� .,�.!C PHONE N0. '` `/ ' ? /G' / <br /> VALUE OF WORK '� f(7(; U� (do not include taxes) <br /> (for commerciZ work <br /> USE OF BUILDING %y���( L l7r/if `( �{�� <br /> NOTE: WAC 296-46-140 requires that plans for electrical work at educational, <br /> institutional or health care facilities be approved by the State of <br /> Washington. Applicants with such jobs must show the State-approved plans <br /> before a City of Everett permit will be issued. <br /> WCRK TO BE DONE: . <br /> ,/I/%r�� acc i9����..l;�r,;;c� i,�r �„�l° �� <br /> �� , � c,: <br /> SIGNED : 1' /_� r r�•_. 1�t DATE �' � � / <br /> NOTES ArD COMMENTS: <br /> 1 ` L�G ��r� - � i,�' ��;i: � l . <br /> � • <br /> 6/10/87 <br /> 1928H <br />