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04/21/2011 10:42 4253778977 BOSCH ELECTRIC INC PAGE 01/01 <br />ELECTR1%.#'ML PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-3810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />2509 '1T—k St <br />PROJECT ADDRESS <br />� � 271,5 ISTM St FyevLt+, wA-- (?87-01 <br />Owner Mall Address city 6latelZlp Phone <br />Tenant Mau Address City State/Zip Phone <br />6oscH E�c�i�SNc. {r_ ?_,ox 1083 I—aVt <br />Electrical Contractor Mail Address City 9talelZip Phona <br />r30sc t Q r <br />State License Number <br />Proposed Use <br />Description of Work to tie Done: <br />NOTE: WIRING IN NON -DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />Contract Price of Work <br />Contact Person (Plan Review) <br />I hereby certify that 1 have read and examined this application and know the same to be true and <br />correct. All provisions of laws and ordinances governing this type of work will be completed <br />whether specified herein or not. The granting of a permit does not presume to give authority to <br />violate or cancel the provisions of any other state or local law regulating construction or the <br />performance of construction. That I am authonzod by the owner of this property to perform the <br />work for which application is made and 1 comply with the Stale Contractors Law 10.27 RCW and <br />296.200 WAC. <br />FEE <br />c.�'�- <br />