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age : 2 of 2 <br />E #3606914517 <br />05/1/2015 09:35 AM T0:14252578857 FROM: Kate Anderson <br />ELECTRICAL PERMIT APPLICATION <br />C[TY OF EVERETT PERMfT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />4502 Rucker Ave, Everett WA 98203 <br />PROJECT ADDRESS <br />Everett 1st Covenant Church <br />Owner <br />Tenant <br />4502 Rucker Ave <br />Mail Address <br />Mail Address <br />Amped Electric & Mechanical LLC PO Box 868 <br />Electrical Contractor Mail Address <br />AMPEDEM907D4 <br />State License Number (required) <br />Commercial <br />Proposed Use of Building <br />Square Footage (If residentiai new construction, remodel or addition) <br />Number of devices (If low voltage) <br />add 7 new 120 volt circuits <br />Description of Work to Be Done: <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />Everett <br />City <br />City <br />Everett <br />City <br />WA 98203 <br />State/Zip <br />State/Zip <br />WA/98206 <br />State/Zip <br />Phone <br />Phone <br />425-583-6414 <br />Phone <br />#048712 <br />City of Everett Business License Number (required) <br />$1500 <br />Contract Price of Work <br />Andrew 5tipech/425-583-6414/andy@ampedelectricalllc.com <br />Contact Person/Contact Number/Email <br />1 hereby certify that ! have read and examined thrs application and know fhe same to be true and <br />correct. AlI provisions oflaws and ordinances governing fhis type of work will be comp(eted <br />whethe� specified herein or not. The granting of a permit does not presume to give aufhorrfy to <br />violate o� cancel the provisions of any other state or loca/ law regulating construction or the <br />performance of constructron. That l am authorized by the owner of this property to perform the <br />work for which application is made and l comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />`��,,�� (L�,,a�a�,.� ��t� ��q 5-1-2015 <br />i,c`.rua.c�ti[ <br />Signature Date <br />HEVISED uB�Ofi/2G74 <br />FEE <br />� ��, ��9 <br />PERMIT# <br />E l�b�- �Z <br />PH <br />