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xxB O H <br />LT G7 <br />C', H <br />fC <br />y i7 <br />W <br />O Cx O <br />CITY OF EVERETT 00 DATE '_ 3 <br />co <br />fn H <br />y r' <br />c <br />ELECTRICAL WIRING PERMIT APPLICATION FEE <br />M O <br />1-3 <br />�1 <br />JOB ADDRESS /�/t-. -77ZI ,0.4o , �- � � �✓G Q-Gi i J <br />O <br />H y 3 <br />Lz1 <br />TENANT c��.��5'/�.C-i%PS C.u.f, i.0 ad %/D� ..3`/7- <br />H y <br />� PROPERTY OWNER <br />gy <br />O U co <br />I@r <br />ELECTRICAL CONTRACTOR ,C Z71-- <br />tzj <br />Z H CO <br />CONTRACTOR'S ADDRESS /y7Oa �V/Llp it r; "A-)T ,p�✓� jZJq/�,,.S t,'i/�G GU! <br />y O 0 <br />CITY ZIP <br />LICENSE NO. EXPIRATION DATE <br />ADMINISTRATOR et14Z/{ dO1'G'TL PHONE NO. <br />/1,, <br />VALUE OF WORK (do not include taxes, <br />(for commerical wo/rk)' <br />/ <br />' USE OF BUILDING <br />i <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 Washington. <br />Applicants with such jobs must show the State approved plans before a City <br />I�1 <br />of Everett permit will be issued. <br />NOTE: Wiring in non dwellings is required to be in conduit. <br />ri <br />U <br />WORK TO BE DONE: <br />SIGNED: DATE: <br />// i'fO DATE: ���� 3//,� <br />3/27/90 <br />U <br />