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05/07/2007 07:19 4253778977 <br />._ �.,�....___ "-------I--�. <br />BOSCH ELECTRIC INC <br />PAGE 01/01 <br />��ECTRi�,�At., ����'�Ifii APPLI�rRTI�N <br />c�-r�r �o� Ev���-r� ���tnn�r sERv�cEs <br />320Q CEDAR S7REET, EVERETT. �NA 98201 <br />425-257-88 �0 - FAX 42�-257-I3R57 —www.everettwa.org <br />APPLICATIONS ARE ACG[PTED FROh9 S AM TO A PiY1 - DEI3�T & �.REDIT CARDS ARE NOT ACCCPTED <br />rl �� P�'ne. <br />PROJECT ADDRESS <br />�Nl� �'7I5_tSr'� s�- ` �veve�'� `�S�I `�'� . 3n3� !1 Z I <br />Owne� M1tail AAdrass ���Y Sta�e�ZiP PM1�� <br />Tenant <br />Eleclrical Contraclor <br />t�c.'�.f� 9�t3 ,� i <br />Sfate License Number <br />ivtail Address <br />Mail Address <br />S� <br />Propased Use of Building '� <br />Descrip:iunof Work W Be 6ons: __ �I..GC�r� <br />NOTE: W IRING IN NON-DW ELLINGS iS REQUIREG TO <br />BE IN Fil10EWAYS, MC OR AC CABIE. <br />CITY OF EVEREIT LOCAI. SAI.ES TAX COUE IS 37 QS <br />Gliy <br />Gity <br />Su1eZu <br />Phonc <br />zs �zS 39�. 7��" <br />SlalefZp �'h�e <br />Cantract P.ice of Work <br />Contact Person (Plan Review) <br />! Ue�eby certify Ihn(1 have read and examined (his npo/rcafion and kno�v (he same to be tn�e and <br />correct. All pmvisluns o(Isws and onfinances Quve�ming I'nis type of work �viA6e comp/efed <br />whefherspeci�eJ hcvein ornoL ThQ pranllnp ofu perm�! does not presurne (o give aufhority to <br />vio( to or cxncel the provisions of any other slafe orlocallaw repulofing construc(ion w tho <br />�om a y� Jch applic�on�s ma+de end l comply Ki h ihe Stale Contre/ cfo spLaw i Q 27 RCW end <br />296.200 WAC. <br />FEE <br />� � <br />JJ� i <br />� <br />b� 3� <br />