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C� F! 23 <br />CITY OF EVERETT �� DAT'r', p,p <br />E7�ECTRIG�L WIRING PERIdIT APPLICATION FEE 3�,Oa <br />�� � JOB ADDRE55 __�q0� ,�q %Jf rLAC� (,(�E�$'i <br />TENANT <br />PROP3RTY OW:IER �J' ELEG7" NOt4.E6 <br />ELECTRICAL CONTRACTOR L- � GLt. E/�EG rrVC, <br />WNTRACTOR'S ADDRESS �O. �JOX. 3�7-ZY- h/RKLA,UU �RCJOS� <br />CITY ZIP <br />LICENSE N0. �SLCELF.Z /Oy�C�j EXPIRATION DATE�__ Z�ZB/90 <br />ADMINISTRATOR '�E,� k(,Q(���' PHONE NO. g�9� �ZZ�C+ � <br />VALUE OF 4IORK (do not i..^lude taxes) <br />(for commerical work) <br />�� <br />USE OF BUILPING ,V�LU �fE"$/pE�U6E <br />NOTE: WAC 256-46-140 regu:r�s that plans £or electrical work at aducational, <br />institutional or healLh care facilities be approved by thn State of 47ashington <br />Applicants with such jobs must show the State approved plans beiore a City <br />of Everett permit will be issued. <br />NOTE: 4liring in non dwellings is required to be in conduit. <br />WORK TO BE DONE: <br />r <br />� �/NtticE L'qa.�Ly ,?s < <'-�.�zj�. <br />SZGNED: _ �„�,(�,��� �. / �� <br />3/27/90 <br />DATE : 7�30��f� <br />T <br />