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07/13/2009 10:13 425377B977 BOSCH ELECTRIC INC PAGE 02/02 <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, GVERETi', WA 98201 <br />425-257-8810 - FAX 425-257-8857—w�wv.everettwa.org <br />-, -► 3-�`'i <br />17 �5��`d � <br />APPI.ICATIONS ARE ACCEpTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />`�3�i pine. <br />PROJECT ADDRESS <br />�N�� d714 i� �t �vE�.c� w� �S?oi �zs.3o3.r�a1 <br />Owner Mai1 Addross City StateZp Phone <br />Ten2nt <br />Mall Address <br />City <br />State2ip <br />Phone <br />�_�,N EI.e�TR.�c.,TnlG t� �vx I G�3 l.�tiE �T�VE�tS,wA.9825$ `��5.3�i787�S <br />ElacMcal ConVactor n�fan address rary s�aie��P anone <br />B�scNELqa�Qr <br />Slate Liconsa Number <br />��� <br />Proposed Use of �uilding <br />Descripiion of Work to 0e D0�0: L�-v'C7���(� u.���z��"�� <br />NOTE: WIRING IN NON-DWELLINGS IS RGQUIRED TO <br />BE IN RACEWAYS. MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CO�E IS 3105 <br />I he�eby cerlify that I have �esd <br />correct. All provlslOns of lalvs 8 <br />whether spec+Iied hero�n or net. <br />viclate or cancel fhe prows�on5 <br />po�O�mavhchapplctetoo 5mc <br />296.200 INAC. <br />thls appfcation e.�d kno�v the same to <br />goveming tnls rypB of w0�k :vil! 6e con <br />�f a pem�R does not presume tc give a <br />lte orlocel law regulat/ng con5trocf/On <br />ized by fbe o�mer af thls F�aPerty to p� <br />y:w�h rhe Stsie Contractors Law 19.2 <br />�--� 3 -09 <br />ConVaIX Price of Work <br />Contact Person (Plan Review) <br />FEE <br />enu �U��" - �`4 l <br />to <br />and <br />