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CITY OF EVERETT <br />ELECTRICAL WIRING PERMIT APPLICATION <br />TENANT Ifs r <br />DATE: j_ �r 7 <br />FEE: .3 n <br />PROPERTY OWNER k— <br />ELECTRICAL CONTRACTOR py it 1 f VVIL Se Cc4 <br />LICENSE NO. (a' �cj L l _ EXPIRATION DATE .3 <br />ADMINISTRATOR PHONE NO. <br />VALUE OF WORK (do not include taxes) <br />(for commercla work)/ <br />USE OF BUILDING <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 <br />Washington. Applicants with such jobs must show the State -approved plans <br />before a City of Everett permit will be issued. <br />WORK TO BE DONE: <br />SIGNED DATE <br />NOTES AND COAMENTS: <br />6110187 <br />1928H <br />