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r, <br /> CITY OF EVERETT �' �` <br /> DATE � � / / <br /> ELECTRICAL WIRING PERMIT APPLICATION FEE <br /> 3c°= <br /> JOB ALDRESS �`�'/(�' .���' rS�C���� �VCF�1 W�/ ��1 C) j <br /> TENANT �.�/i/27l(IlyT /o"f /l���Lr% <br /> PROPERTY OWNER <br /> ELECTRICAL CONTRACTOR C��/%��4 ` /G <br /> CONTRACTOR'S rwo�ess n a �-/ �1�G�2n/t,%� ,�7/£� . CI�;��'�'j�, �,�/,/�f�jU� <br /> �'- �CITY ZIP <br /> LICENSE NO. �" -/V� �� ��'l�N/� EXPTRIITION DATE � Cl `�d^ � � <br /> � � <br /> ADMINZ:iTR11TOR ���jf�� � �f-C� PHONE NO. A� S�` ���,� <br /> ��1 � <br /> V11LUE OF WORK � �� 7�v (do not include taxes) <br /> (for commerical work) <br /> USE OF BUZLDING _ C� � ��-(`f1IyS U �� � <br /> NOTE: WAC 2°6-46-140 requires that plans for electrical work at educational, � <br /> • institutional or health care facilities be approved by the State of Washi�. ji <br /> Applicants with such jobs must show the State aporoved plans before a Cit; kS <br /> of Everett permit will be issued. <br /> NOTE: Wiring in nan dwellings is required to be in conduit. <br /> I90RK TO B DONE: <br /> i �/ <br /> (� l�O�. /�� �<Jl£'s-'L/'�C' �/z�f.�i�t �S�i�..t - <br /> SIGN : � �7 q / <br /> J� ��� DATE: � � / � l ( <br /> _� B ��07 <br /> .� �� _: _ <br /> � T� � � ,.:.� �„r .�r�,.t <br /> f '.: ' ..- r .'; _- - `.� 4, IY ,i?' .R <br /> �, .: � :�, �y.. <br /> li—fi.x'.� ._ __ ._ l�_' __._.' ___�.uLn � __ �— _—__ ��___ .__ ..—__ . . �Y*". ..c<_"�C'� �-.�._. <br />