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11/26/2008 11:13 4253778977 BOSCH ELECTRIC INC PAGE 01/01 <br /> . � � --��'---1 1._��__----- <br /> ELECTRICq� pERMIT APPLICATION <br /> C�7�1' OF EVERETT PERMIT SERVICES / p <br /> 3200 CEDAR STREE7 EVEREn, WA 98201 ��`'a b�-Da <br /> 425 257-8810 - Ff�(425-257-gg57-�y�y,everettWa.org ,� <br /> �4PPLICqT10NS qRE qCCEPTcD FROM 8 AIN 70 4 PIN -DEBIT&CRE��T CqRpS ARE NO�OCgpTE� �/ <br /> 3Zlo He�.th�r Rd_ . <br /> PROJECT ADDRESS <br /> �I wooc�. 3z6 � +6..cr (?oF. �v�r�t� uJ� 98zo3 <br /> Owner MailAddress `'�'�s. µ'L2.q/(p <br /> ��ry sataap anone <br /> I Te�af' � Mall Addross - <br /> City SIat92ip P�ane <br /> $�scti ��.cm� � � +�x ��e3 �a� St-�v�.s, �.vl� R8ZS8 ���q�s <br /> Electncal Contractor Mail,addrese : c�ty staal[ip phone <br /> t�Osr,�-i'EZ9R� t�7 <br /> Stato License Number � � � <br /> � Conlrad Pnce of Wo�k <br /> s�� <br /> Proposed Use of Owlding � � . . Contact Person (Plan Raview) � - <br /> Description ot Work to Be Dunc; �p(�Q J� �����` � � � � � � <br /> NOTE: WIRING IN NON-OWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERE7"f LOCAL SALES TAX CO�E IS 3106 I--, � � 1 � <br /> I hereny ceRify thef 1 have read and examined lhis applicatla�end k��ow the same to 6e true and `— ubl f � I �� <br /> cor�ect A/l provisions o//aK•s and o�ainences goveming this typa of work will be completed <br /> whether spod(ied hurein or not. 1"No granring ol a ps�mrt Qoes na(prnsumo to pive euthodry to <br /> violate o�cancel fhe prOv/sions o(any c;her stafe orlo^al law raguleting constnietlon or the <br /> pedormnnce o(canswction. That 1 nm autherized by:ho cwne�o(this oroperty ro perform!he � . <br /> work fot which applica(ion is m�de miJ!comply with the Slafo Confractors Lnw 1�.27 RCW and <br /> 29fi.200 WAC. <br /> ,� �I - a�- ag <br /> Siqnaulr p��e <br /> � <br /> .�t <br />