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02101/20�7 14:47 4253778977 BOSCH ELECTRIC INC PAGE 01/02 <br /> c � <br /> r-------- - <br /> � <br /> ELECTRICAL PERMIT APRLICATION <br /> CiTY OF EVERETT PERMIT SERVICES p�� o <br /> 3200 CEDAR STREET, EVERETT, WA 98201 7' '" 7 <br /> 425-257-8810 - FAX 425-267-8857—www•everoitwa.org �O�p Z..Q O 7 <br /> qPPLICATIONS ARE ACCEpTED FF20M 8 AM TO 4 PM -DEB{T 8 i:RED1T CARDS ARE NOT ACCEPTED <br /> 1 a i `l He�rn,lcc lc� <br /> PROJECT ADDRESS <br /> �t� �� ts Is�" �Si� �veret�fi � ��z� ( �lzs3U3. i1�-i <br /> pyynef Mail Atldress City State/Zip Phone <br /> Tenent Mail Atltlress Cily StalelIIp Phone <br /> X�oScl� �I�civic.�c, PDB�x IDR� Lakzsfe�eu�s t� °�gzSg �f�� ��� �?�S' <br /> lectrical Con[ractor Mail Address City s�ate�2ip Pnone <br /> ��G����i3 q�' <br /> State License Number Contrac[Price of Work <br /> Proposed of 6uliding Contact Person (Pla�Review) <br /> Oeccription of Work to Be Oune: 1�0 "vy��� �2 r� <br /> NOTE: WIRING IN NON-DWELLINOS lS REQUIRED TO FEE <br /> BE IN.RACEWAYS, MC OR AC CABLE. � <br /> ClTV OF[VEREfT LOGAL SALES TAX CO�E IS 3106 <br /> 1 hereby co�flfy thaf f l�ave read and oxamineAthls appllcatlon and know lhe same to be Vue and cU-j OZ 'aj'� <br /> correct Alf pravisions oflaws and ordinancas 9ovomin9 thts type of work wit!be aompleted L I <br /> whe�her spocified hereln or not. The grenting of a pemut does not r�sume[o giva authonty to <br /> vldafe or cancel lhe provisions ofeny otMr stata or local law r�pu�ting cou�rudion or ths � I <br /> peiiwmanco o/conslruction. Tf�af I em authodzed by(he owr�er o/thrs propeRy fo per(am the � <br /> wwk to�which applicatM_n is made and I comply with the State Lbntrac(ors Law 78.27 RCW and <br /> 296.200 WAC. r` <br /> � r <br /> •� ' � 1 0 7 <br /> �.. a T� C�31E <br />