Laserfiche WebLink
77 y <br /> Fa CO CITY OF EVERETT DATE_ <br /> H 3c, <br /> K fHi ELECTRICAL WIRING PERMIT APPLICATION FEE ,�� <br /> HW <br /> Vi H JOB ADDRESS <br /> TENANT <br /> OH <br /> �j PROPERTY OWNER /iVilti reiNS <br /> a. 0 <br /> Z y ELECTRICAL CONTRACTOR _ �f/O,✓o+����J/� GOu.vTN /�ed�'e le / <br /> O y i3 <br /> CONTRACTOR'S ADDRESS f Q /�OX //D 7 .[i/Grl� >i /cf ?�'C• <br /> H CITY ZIP <br /> 0 t7 V1 <br /> LICENSE NO. EXPIRATION DATE <br /> x Hto <br /> H0 N ADMINISTRATOR PHONE NO. 9S U7� <br /> 'Pj 6.!$ '7 <br /> VALUE OF WORK (do not include taxes) <br /> (for commerical work) <br /> USE OF BUILDING <br /> NOTEt 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 /> of Everett permit will be issued. <br /> NOTE: Wiring in non dwellings is required to be in conduit. <br /> WORK TO BE DONEs <br /> !_11 <br /> ry <br /> SIGNEDa - � DATEe <br />