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�r� <br />�y <br />p �1 5 <br />YHc~n <br />rx <br />Haa <br />y xH <br />�e o <br />O x0 <br />'+7 H'SJ <br />V1 H <br />E� O � <br />OH� <br />��g <br />� Y �] <br />ay� <br />r z <br />HH <br />g� <br />H <br />c� t7 m <br />� t� t� <br />t�1 <br />H O fy/� <br />CITY OF EVERETT <br />CATE: jj-�27— �l <br />ELECTRICAI_ WIRING PERMIT APPLICATION FEE: 3;; �7%� <br />J06 ACDRE55 3Oo"] o2/sr S7�icrE' � <br />TENANT <br />'f', C A� 7/ <br />PRCPERI Y OWNER �,o�v. �9 S-Z /`.�,�/' /2 <br />ELECTRICAL CONTRACTOR �%_ -�j�w f�/ ��r�� Tn_: C� _ <br />ELEC. CONTRACTCR' S MAZLING ADGRESS , �o / � �/'v ir, { ,^'L _ <br />LICENSE N0. /J,^C 6/iv _%�/� `��'% EXPZRATION DATE „? - � � - �� <br />ADMINISTR{ITCft �%f'� /,';'��/,cJ �/ PHONE N0. � Sc�� �/�-�! % <br />VALUE OF WGRK --� (Co not include taxes) <br />(for corrmercia wor <br />USE CF BUILDING _�� �; /� p� . �� �i <br />NOTE: WAC 296-46-140 recuires that plans for electrical k�ork at educational, <br />institutional or health care facilities be aoproved by the State of <br />'Aashington. Fpplicants xith =_uch joGs must shcw tr�e State-approved plans <br />bef'ore a City of Everett cermit �Nill te is=ued. <br />WCRK TO EE DONE: <br />�t'2,)�< <br />0 <br />i1 <br />SIGNED : r ^ �G< -'% DATE (/- � � _ ,F"� _ <br />/ � <br />NOTES AND CONME^1T5: � - <br />