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Apr 15 2016 9:39AM Bosch Electric Inc. 4253778977 page 1 <br />�'1L��T`�ICAL PERt1111T` �PLICATI�tl1 <br />CITY OF EVERETT PERMIT SERVECES <br />(P) 425-257-881 Q J FAX 425-257-88 7 j�E) e e etieps@everefiwa.To�A 98201 <br />9 f �w.everettwa.gov/petmits <br />� PROJECT SITE iNF�RI{t1A,�`(ON :: � <br />PFtO.fECT AbDRESS: � . �.� . <br />g�1�LD�NG AREA (if residential, new consiruciion, rernodel, or addition) gp <br />BUILDlNG T1(pE. 0 SFR-DE7ACNED ❑ SFRATTACH�D L7 DUPLEK ❑ MULTf-FAMILY-� OF tIN <br />U5E OF Bi11i.pING: G�,(r(,v�` . <br />CONTR,QCT PRICE pp �yp�; $�'j'DD� b0 <br />NUMBER OF DEVICES if low volta e: '—` <br />FIRE ALA,RM? 0 Y,ES (�¢p <br />ASSOClq1'ED BUILDING PERMIT # {if epplicaE <br />DESCRIPTION OF WORK: �r�m.� r� <br />r��: C�I�.c.i.v�.�., <br />MAI[JNG ADDFRESS: <br />OWNER PHONE: �Z� <br />-�-�� �. � <br />CON7RACTOFt NAME; <br />ciTr <br />CONTRqC70R PHONE• � � 3G�' <br />CONTRqCTQR LIC, �EQUIRED): /� <br />PRI�AARY CONTACi: [] flWNER I <br />±OM'ACT NAME: <br />AGREEMFM 7 haie�by ceryly that I heve read and examined this i <br />�°�wak wyY�be wmp/eted whethetspedNed herein ornof. 7he <br />locallewregulafing consfruction orthe pelfomra,xx� ofcons���on. <br />comp�y wifh the SYate Contre�fors (,ayy 18.27 RCW and 2gB.2a0 ENA <br />AL A� <br />CONTACT IM�� <br />�� 7EN/ <br />� �lA�WI. WLI'�'" i, <br />r� <br />OWNER EMqIL: <br />L T*it- � . <br />NIATION � . . .... . - <br />NAME (ff Commercial): �A,yypr <br />� <br />�OMMEI�CIAL <br />Jt��- � s�. <br />- - - �► 37A'F� � ZIP W �� <br />COH7RACTOR EMAIL: �T �!� e �C�ir'iL ;� �,�� � , �� <br />� a� C1TY �F EVER�TT BU5INESS LIC. � REQUIRED); �� "] 7 <br />❑ OTHER (Please5pecify) � <br />CON7ACT PFiO1VE: � Z ��. A ` <br />F Cc�l <br />GONTqGT EMqlL; � � <br />` � -� <br />�tlon and know the same ta be true and co�r.� Ap provrsions oflaws and ordinencas goveming this <br />ng of e pemrlf does not p�sume fo g�1�e aufhority ta via/ate or ca <br />l am authorrzed �� �e,orov/sions of eny otherstefe ar <br />bY the owner oFthia properfy to per{orm tile nrork for which eppB'cation ls mede end ! <br />City of Evereft Ofi9cial Use On/y <br />F�E <br />� �- �b <br />�� � � � <br />PERMIT # <br />� � �� � � � <br />(Revised 90/1212p�5� <br />