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, <br /> i <br /> I <br /> I <br /> � <br /> � <br /> c:rr ce i:cr-.�u::r DATE� - <br /> GLECTRICAL WIRING PERMIT APPLICATION FEE ✓��� ___ <br /> � �� :,��� <br /> � �oe twot�ss ���,t 9 //G `�" /� . .�, r � '�-t-� �ir <br /> � y y TENAi4T /�.'l��a ,�d�sfi'u�/iav �y��iE� — <br /> y � � PROPERTY OWNER .�iY/�L i/- L //�'/�. TI1�f'f✓�� — <br /> � �p ELECTRICAL CONTRACTOR 'v�L(/��L�Y�/ � CCN���� CYS�[`/Nf L�•�C • _ <br /> '+tl H 'i1 —�7 � �, a <br /> W �'* �l�i�er1T `�i�. <br /> '� y. corote,�croe,�s r,nnE�rse 7 �/ � � /� ��tie6 --- <br /> � �� �' CITY ZtP. . <br /> � [�i g LICGNSEi :Jn. ;�.� 1�.�1 �- I rS�ZI �i��� GXPIRATION DATE �/r//r� _ <br /> n� � , <br /> �"� :i r /� .T � PHONG NO. `-:/ � - ( i�� <br /> Z y � i�L:AINI51'RATOR � j L'!l L/�, t I — --- <br /> y <br /> �.y H vALUE oF wORK (do not include taxorJ <br /> O y H (for commerical work) <br /> �tg7 N <br /> f°�j ose or euiLoiNc ,�G/��si/�Ei✓« _._____—___------ <br /> y � y t�CTG: WAC 29G-46-140 requires that plans for electrical work i[ educational, <br /> ins[i[utional or health care facilities be approved by the State of Washinqton. <br /> � APPlicants with such jobs must show the State approve�l 7-�lans Lrfore a Ci��;; <br /> of Evere[t Fermit will be issued. <br /> i <br /> NOT�: WiLin4 1❑ nnn �1�.�rllin�= is ro�;ci���l t�. 1.�• �n con�hu�_. <br /> C� <br /> WOF}: 'PO PF. D(:t1P:: <br /> / <br /> �I __ <br /> �(- C!�/ /I� •r' -.-i� ri � "_ uo.� _, lr� c__'_—_—___'___ <br /> �� <br /> �1� ___—— <br /> J ' i , � � � . �. .;� . <br /> � SIGNED: .� ' . -� i � .-..�� ,� . � DA'?'E: _, <br /> , _a.—__.—_____—.____ ._.____ ..—__�—_—__._ -._ --- —. <br /> \ <br /> 7/27/^.t: <br />