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a�e : 2 of 2 0�/22/'1.015 U7 : 20 PM TO 1925257U457 FROM ISate Ander.on F <br /> NE f13B06914517 <br /> I __ � -- -- � II <br /> Ir <br /> ELECTRICAL PERMIT APPLICATION i <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> � 425-257-BE310 - FAX 425-257-8857 - www everettv✓a.org <br /> I �a3`' s ! <br /> - � � sob-�b� <br /> I101 Har6aia Wnn F.v�rrll WA 982C3 � <br /> PROJECTADDRE55 li <br /> 1n�n•IP��rlr lO1 �arWiial.ane fvereV WA9(1?03 C?5�?38-0G1J <br /> . ._.___..____' _. ""'_ --._- . ___ -_ <br /> � O�nTe� Meu AtlG�:ss Gty Stele2�D Phone <br /> � I <br /> __-._ - -__ I <br /> Tenant M1�ed Addresz Ciry Slale20 P�one <br /> I Amped Elecmc [i Mecnan�c�i LLf PO �ex A�iC, Fverelt WAI9A206 425-SHi-6414 <br /> LletVical Contrador Men Atld�ess Gty Slale2iD Phone <br /> II AMVCDCM507D4 . k0A8712 I <br /> �� State L�cense Number �requved) Gty of Everett Busmess license Number�requned) <br /> SmGlc rarnily Rn.ti�tlr.nGc 570000 __- _ <br /> Proposed Use of HuJdmg Contract Pnce ol Wo�k . <br /> AnAy SUpech/i25�587 6a 17l anQyq:�ampedeRclndic com <br /> '�, Square Footage pf resideM�al new consL•uctwn, remodei or adddion) Conlact Person/Comxt NumbedFinad <br /> I <br /> INumber of devices(If low voitaye) <br /> Cncuds for Fumncc � <br /> Desttiption ol Woik lo Be Done - _ --- —_- '- I <br /> I - -- -- <br /> i <br /> I --- - -- - -- - --' - -- � -- ----�- -- <br /> PEE _.. .._ <br /> I CITY OF EVERETT LOCAL SALES TAx CODE IS J105 � G r��� <br /> I � V � <br /> ' I hereby certJy fhat 1 have re�d and eaam�neJ flns applicafron und know(he sarne fo be 6ue and L__' _ . _ �. <br /> conecf All prov�s�ons o!ldws nnd ordrnunces 9ovr.rninn tfus lype o/wo�F wdl be conrplrted � I I <br /> mhefhrr spealied herem�,r no� The granGng nl a prrmrl does nof presume(0 9rvc aufhonry fo r p[RMI T# <br /> wo/afe or cancel lhe prov�s�ons ol any olher slate or local law regul.if�ny conslruclron or Ihe ��, <br /> peiformance o!consf�ucfion 7ha1 I am aufhorized by fhe ownei ol this property lo pedorm!he E 1,�� I� �, <br /> worw lor wh�ch app6cahon�s made and I comply wAh Ihe Slate CoMincf0�5 Lnw 18 7.7 RCIV and �_ _ ���� _ _ I <br /> 29ti 700 WAC <br /> , <br /> : �ul< l`U.�J<�eon P-_��E015 <br /> S�gnalwe Datc � <br /> I <br /> ' u��...;0.'tlrnivv '�, <br />