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CITY OF EVERETT <br />ELECTRICAL WiRING PERMIT FaPPLICAT?ON <br />JOB A�DRcSS <br />TENANT <br />DATE: <br />FEE: s�t�.00 <br />i Ill�� v"1 "�L'q l,�l.V� <br />PROPERTY OWNEFt S n;•1 E <br />�_ECTRICAL CONIRACTOR nit7�x's �io`�c st.cunr'1't' �— <br />LICENSE N0. BR1;�K'S HS 149Li: <br />EXP?RATION DATE ;q L't 1 19 q o <br />PHONE N0. 575-0'+97 <br />ADMINISIRATOR <br />VALUE OF WORK ��� "•� � —_�do n�t include taxes) <br />(Por cornmercie. work <br />USE OF BUILDING LKESIDE>:TiAL�/ Commercial <br />NOTF: WAC 296-46-140 reauires that plans Por electrical work atthedUStaten�oP <br />institutional or health care facilities be approved by <br />Washington. Apolicants with such jobs must show the State-approved plans <br />before a City or Everett pe:mii will be issued. <br />WORK TO BE DONE: <br />Ins ection of Intrustion �11nrm• <br />� <br />SIGNcD : �'�`� l I ( '(i' '����-) _ DATE � <br />PlOTES AND COMMENTS : <br />6/10/87 <br />1928H <br />