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12/65/�fl08 10:46 4253776977 <br />BOSCH ELECTRIC INC PAGE 01/01 <br />( _ <br />ELECTRICAL PERMIT APPLICATION <br />C17Y OF EVERETT PERMIT SERVICES ����� <br />3200 CEDAR STREET, EVERETT, WA 98Z01 <br />425-257-8810 - FAX425-257-8857—�ww.everettwa.org tr.pg/Z—.O�'J <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />`'tS a-� . L� rld,e vl <br />PROJECT ADDRESS <br />�(�'A �"7fS I�` S�" FV2rt�ft" 3 V�ft �BZ� { y�2s. 3a3: I� a J <br />Otvne� Mall Address CIC/ - State2ip Phcne <br />Tenant <br />iL <br />Electrical Contracmr <br />Mall Address <br />hlall AriAr�s; <br />�oS�HE29�3Q i <br />State Licenso Number <br />r�t �a <br />Proposod Use of. Building <br />Description of Work to Be Done: ��C-� � <br />NOTE: WIRING IN NON-DVVELLINGS IS REQUIRED TO <br />BE IN R.ICEWAYS, MC OR AC CABLE. <br />CtTY OF HVGR(_TT LOCAL SA�ES TAX CODE IS 3'105 <br />� <br />Ciry <br />c�ry <br />StatcQip <br />vei�,�w� � <br />Slale�Zlp <br />Contract Pnce of Work <br />Phono <br />yas . <br />Contact Person (Pian Review) <br />I hereby ceRify fhat I have reaa and examined this �aA��cation and knew fha same to be true and <br />correcr. Al1 provisiuns oi laws antl orclinances governing tnis type cl work �vill be completed <br />whefher speci/ied herern or noL The g�anting of a permd does not Presume fo give authority fo <br />violafe or cancel the provisiens cl any oeher sfate er lecal le�v regulating construction or the <br />peAcrmance ol canstn�ction. 7hat 1 em authodzed 6y the cwner o(this o�operiy to peNorm ihe <br />we�k 1ur which app�icetion �s macle and � cumply wlff� the Stafe Contrac:ors Law 78.27 R. CW and <br />29ti.200 WAC, <br />FEE <br />Pnone <br />