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Oct 17 2011 10:12AM Bosch Electric Inc 4253778977 pa9e � _ <br /> � �.. <br /> ELECTRICAL PERMIT APPLICATION <br /> ' CITY OF EVERETT PERMIT SERVICES Jn����// <br /> 3200 CEDAR STREET, EVERETT, WA 98201 �l//O�� <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> APPLICATIOIJS ARE ACCEPTED FROM 8 AM TO 4 PM -DEBIT&CREDIT CARDS ARE kOT ACCEPTED <br /> �� <br /> �-fi �'"a�cd�,, S'�e �- <br /> PROJECT M�RESS <br /> 38��'( <br /> CLu(Ct�� �' L-lil I� A�-fi�tn C�JeYefi�� Wf�'� `�g'ZO� '�l ZS'. 2(2,41 5 <br /> Owner � Mall ddress Ci ShateZp Phone <br /> Tenant Mail Atldress Clty � Slato2Jp Phoro <br /> �3oscc�. �cfi�;c��c, Pt� F�ok log'3 I.I�S�ucu�s w/!- 48z 4z�ia� 87��` <br /> ElecMpl Contractor Mall ndd�es3 Gy Smto/Z�p Phon� <br /> _-P�oscH-EL�1a3Qr �a�30�°� <br /> State Licxnse Numbar Contrad Price of Work <br /> Prnposed Use of Building Conhact Person (Plan Reviewy <br /> Desr.ription ofWoik W Du IJono: �1 e-ka�t (Y1/�� YaVFVI/�t�5/ �I.AQ.{"�lL�/ <br /> NOTE: W IRING IPI NON-DW ELLINGS IS REQUIRED TO FEE <br /> 8E IN f2ACEWAYS, MC OR AC CABLE. <br /> CITY OF EUER�'i LOCAL SALES TA7(CODE IS 3105 <br /> !hereby cer6Yy thef!have read and ezarnir.ed fhJs epplicaflon and know the same ro be We and <br /> coneet. Al!provisions o/laws and ordinanceas,00veming fhls lype o(work wiN be completed <br /> wheMer speci(ed herein or nol. Tho granf(np of a pemnf does not p25ume!o give eufhonty to � <br /> vidate or cenco!lliep rovisions of any ot;er sfate orlocal!aw regu/afing constniction or tho , 2 <br /> oeAormance ot construcNon. 7hnt I am authnrized dy the ownar of thls pmperfy fo peAorm fhe I a <br /> ,vork Iw which aoplicalinn is made and I comply wlth the Slafe Conhaclors Law 18.27 RCW and <br /> 296.200 WAC. ( <br /> �o- ��-� r <br /> ignh� e Date <br />