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age: 2 of 2 09/10/2015 11:37 AM T0:14252578857 FROM: Kate Anderson <br />�E #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 />3009 Gedney St, Everett WA 98201 <br />PROJECT ADDRESS <br />Josh Burleson <br />Owner <br />Tenant <br />3009 Gedney St. <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 furnacc <br />Description of Work to Be Done: <br />City <br />Everett <br />City <br />WA 98201 256-975-2493 <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 5tipech/425-583-6414 �andy@ampedelectricllc. <br />Contact Person/Contact Number/Email <br />FE E <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 31U5 � C� � ��-��, <br />✓ <br />l hereby cerfify that I have read and examined this application and know the same to be true and <br />correct. AIl provisrons of laws and ordinances governing ihis type of wo�k will be completed <br />whefher specified herein or not. The granting of a permlt does not presume to give authority to PERMIT# <br />violate or cancel the provisions of any other state or loca/ law regulating constructron or the ��,,-- ,, �' Q� � <br />performance of construction. That l am authorized by the owner of this property to perform the �%� i� , <br />work for which application is made and I comply with the State Contracto�s Law 98.27 RCW and <br />296.200 WAC. <br />�cl,%e �nasrrd.an <br />Signature <br />H1-VISED US�Oo/7G74 <br />09-10-2015 <br />Date <br />P <br />