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age: 2 of 2 09/14/2015 11:07 AM T0:14252578857 FROM: Kate Anderson P <br />KE #3606914517 _ _ <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />46� 2 Seahurst Ave, Everett WA 98203 <br />PROJECT ADDRESS <br />Don Carter <br />Owner <br />Tenant <br />4612 Seahurst 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 />Single Family Residence <br />Proposed Use of Building <br />Everett <br />City <br />Square Footage (If residentiai new construction, remodel or addition) <br />Number of devices (If low voltage) <br />add two circuits for furnace <br />Description of Work to Be Done: <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />City <br />Everett <br />City <br />WA 98203 425-252-6067 <br />State/Zip Phone <br />State/Zip <br />WA/98206 <br />State/Zip <br />Phone <br />425-583-6414 <br />Phone <br />#048712 <br />City of Everett Business License Number (required) <br />$300.00 <br />Contract Price of Work <br />Andrew Stipech/425-583-6414 /andy@ampedelectricllc. <br />Contaci Person/Contact Number/Email <br />l hereby certify that 1 have read and examrned this app�rcation and know the same to be true and <br />correcf. All provisions of laws and ordinances governing this type of work will be completed <br />whether specified herefn or not. The granting of a permit does not presume to give authority to <br />violate or cancel the provisrons of any other state or local law regulating construction or the <br />performance of constructron. That I am authorized by the owner of thrs property to perform the <br />work for which application is made and l comply with the State Contractors Law 98.27 RCW and <br />296. 200 WA C. <br />��pQ (c�1�4� 09-14-2015 <br />Signature Date <br />REVISED ciB�Oti/'IU74 <br />FE E <br />���,��=� <br />PERMIT# <br />E I�� �'��� <br />