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91/18/2011 10:03 4253778977 <br />\ <br />BOSCH ELECTRIC INC <br />---�.. —� -- <br />PAGE 01/91 <br />ELECTRICAL PERMIT APPLICATION <br />C�TY OF EVERETT` PERMIT SEF3VICES �,�� ��-(� <br />3200 CEDAR STREEf, EVERETf, Wq gg201 <br />425-257-H810 - FAX 425-257-8857 — www.everettwa.org �� jQ (�"O�� <br />APPLICATIONS ARE ACCEATED F RO M 8 A M 7' p 4 PM - DEBIT & CREDIT CARos ARE NOT nccEPTED <br />bl L;h�Q� <br />PROJECT ADDRESS � <br />��f�A- �715 1�TM <br />•awr-�; <br />Tenant <br />MaA Adcfress <br />Mail Addrecs <br />�98zo1 � <br />City <br />C(ty <br />S 3a3 I12 I <br />31ate/TJp <br />Stala2lp <br />Phone <br />Phone <br />��5�� F�ect�v;�.SNc.•. P0+'., Io83 Lalu. Sizvutis, W�t.QSZSS y2s3�i�87�O� <br />ElectricalContractor MailAddreys Gly � StaWZip Phone <br />P�USC1�i ET <br />Sfate License Number <br />S �- <br />Propused Use of Buflding <br />Descrlption of Work to Be Done: <br />NO7E: BERN �CEWAYS MC O' R AC CABLEUIRED TO <br />Contract Prica of Work <br />Contact Parson {Plan Review) <br />CITI' OF EVEREIT LOCAL SALES TAX CODE IS 3'105 <br />I heredy cartNy fhot ! lrave rriad snd examined thls app�icatlon and know the seme to be vue and <br />correct. All provis+ons ollews and orcfinances goveming thls lype of work w�ll be. completed <br />wheiher spnafied harein o{ not. The grentrng ef a peimd does not Aresume ro grve aufhortty to <br />viola!e or cance! fhe provisions o/ any ofher sfate or loca/ lew re9ulating consfructlon or fbe <br />perlomrenca of const�ucflan- That 1 am auihorized by the owne� of lhis property to per/o�m ifte <br />work lor whlr.h app���otion is made and 1 comply with fhe State Contracfors Lew �H.27 RCW nnd <br />236.200 WAC. <br />rir� <br />FEE <br />r� <br />�� o r -�sa <br />