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CITY OF EVERETT � . DATE �-Ly -QJ <br /> ELECTRIGIL WIAING PERNST APPLIGiTION FEE_� <br /> d0H AbDFiE55 L�' �� / ��A i /� � ,- I� �"_ <br /> TENM]T � A"' : < h � � �/ I.J 1 .t "�} i /1 I: � r � <br /> / <br /> P50PEATY OWNEfi � r y r <br /> ELECfRICAL CGNTRACTOR � � A �h � I "I�C h ��. � <br /> CONTRACY'OR'S ADDAE55 '� �� � L( I�s.! !� J GJ A4' �I/Ci L-I-I �� �/ /� .> <br /> �r— CITY ZIP <br /> LICENSE N0. N AM�C. Lr! �L �-�'N Iw� EXPIRATION DATE �' � " _ T C�� <br /> ADMINISTRATOR � )/�I t'_ I'� A m �I TDh PHONE NO. � S�S - J � / � <br /> VAI.UE OF WORK �.���/�('. (do not include taxes) <br /> (for commerical workl T�— <br /> 1 I- I 1 <br /> USE OF BUILDING �� �t2 Y' ��� 1 S 'r Y� � h ji 7' > / <br /> NOTE: WA� 296-46-140 requires [hat plans for electrical work at educational, <br /> institut?onal or health care facilities 6e approved by the State of tPashington. <br /> Applicants vith such jobs mus[ show the Sta[e approved plans before a City <br /> af Everett pezmi[ will he issued. <br /> NOTE: Wiring in non dwellings is xequized to be in conduit. <br /> WON: TO EE DONE: <br /> SIGN6D: � �� '.�.� ��. Del� C <br /> 1/27/9P <br />