Laserfiche WebLink
11/:�9/2610 15:35 42�3778977 BOSCH ELECTRIC INC PAGE 01/01 <br />�LECTRICAL PERMIT APPLICAioON <br />CITY AF EVERETT PERMIT SERUICES _ <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 -- www.everettwa.org <br />APPLICATIONS ARE ACCEPTEO FROM i3 AM 70 4 PM - oEBIT & CREDIT CnROS ARE NOT ACCEPTeD <br />�U`-f L�hde�� <br />PROJF.CT ApDRESS <br />%��B 15�} 7 QSZG"'( <br />_Et-t� �71 S �__ Ev�r�t-+ <br />OtVnef Mai! Addro;� Ciry <br />Tenant <br />;c.l� El,ci,iti, c .lw <br />Electrical Contractor <br />gosc�tcl�t�3� r <br />Slate License Number <br />�K— <br />Proposed Use of 6uilding <br />�escripllon of woric to Be oone: <br />Mail Addtess <br />� �x <br />Mail Address <br />iVOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CIty <br />ciry <br />w�+ . <br />9l `lZ�3S3, jI <br />StafelLip <br />Stale2ip <br />RBz� yz <br />StalelZip <br />Contract Price of Work <br />Contad Person {Plan Review) <br />C17Y OF EVGRETT LOCAL SAL�S TAX CODE IS 3105 <br />1 hereby cortify ihof ! have read and exam;ned th!s ap�llcafion anU know the same fo be frue and <br />cerrocl. A!I provls�ons of tnws and ortYlnnncos govr:rn�ng this ;ype c4Vtrodf wilf ba carp(efod <br />whcthar spec/fred herein w noL Tha Qranhng of a permrt does nnt uresume fo pive authonty fo <br />vicl�7o �r concel fhe pirovisiuns of any ofher �tafe o�local �aw �egulsting consf.uction or Ihe <br />pedamance ul..onslrocL'on. Thaf I am auth�xized by the owner of this prvperty to perform fhe <br />work lor whiclr nppiication is made and ! cornpiy wiYh tho Slafu Cunlrvclors Lsw iB.27 RCW and <br />19ti.200 WAC. <br />� / - �-0] -/ i� <br />L <br />"EC- <br />.../ <br />I /�� <br />P�one <br />Phone <br />Phane <br />