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CITY OF EVERETT � a � ou � �I <br />Q.ECTRxCAL WIRING PERMIT APPLLCATION <br />rd <br />�ar�. r.<1 <br />FEE ; �S�,n _ n n <br />JOB ADDRESS I I V-i .� "• "'-- <br />. � � I I (' �- � .�,�- <br />TENANT � <br />PFlOPERTY OWNER SArie <br />� <br />ELECTRICAL CONiRACTOR BRI'.:K'S N0`1E SECURITY <br />EXPIAATION DATE �•• n nu ";l q9' <br />LICENSE N0, BRINK'S HS 148LE `t: <br />PHONE N0. 575-0497 <br />ADMINISTRATOR <br />VALUE OF WORK 95•�U <br />(do not include taxes) <br />(Por commercia work <br />USE OF BUILDING RESID?�T?AL ( Comr.�erc+al `�. <br />NOTE: 1Astitutiona140oreQhealth tcate pfacilitiesebeCtapprovedrby�ttheduStatenaaf <br />before9a CityAof lEve ett pe:'^�isUW='-'-� be issued show the State-approved Dlafls , c�. <br />WORK TO BE DONE; . <br />I <br />f <br />� k•. <br />� h O D Q�'11 r i`.t .tZ � r�'L-trx�' �7ATE <br />SIGnED : <br />NOTES AND COMMENTS: <br />� <br />6/10/87 • <br />1926H - <br />� <br />• i <br />