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i <br />ay <br />C H <br />a H5Cn <br />rr+b3 <br />y YZ <br />CITY OF EVERETT '. <br />DATE <br />S :_ <br />a x 0 <br />ELECTRICAL WIRING PERMIT APPLICATION <br />FEE <br />V +7 <br />O M <br />a % 7 `J s7 ;>J-= . . <br />1�7 <br />Hd <br />JOB ADDRESS <br />0 H <br />H g <br />TENANT <br />�tAl U )) <br />M <br />PROPERTY OWNER <br />H <br />C <br />H H <br />ELECTRICAL CONTRACTOR <br />y <br />H <br />nq CJ y <br />C: <br />CONTRACTOR'S ADDRESS <br />r <br />CITY ZIP <br />P7 [4 <br />q 0 C� <br />LICENSE NO. EXPIRATION DATE <br />ADMINISTRATOR PRONE NO. <br />VALUE OF WORK (do nat include taxes) <br />'. <br />(for commerical work) <br />,/ <br />USE OF BUILDING /�-�Y �7 "-0„,J <br />NOTE: WAC 296-46-140 requires that plans for electrical work <br />at educational, <br />• institutional or health care facilities be approved by <br />the State of Washington. <br />Applicants with such jobs must show the State approved <br />plans before a City <br />of Everett permit will be issued. <br />a � <br />NOTE: Wiring in non dwellings is required to be in conduit. <br />WORK TO <br />)BE/DONE: <br />SIGNED: DATE: <br />