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3�e: 2 of 2 <br />W2069�1550� <br />� <br />12/29/2019 13:1'I PM T0:14252578857 <br />— — --. <br />FROM: DonnaBarner �HO <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 — w�nnv.everettwa.org <br />, � -a4 -�y <br />Cl4�a-�C� <br />6611 6eveny B�v,' <br />PROJECT ADDRESS <br />M1�an n Se��y <br />Ohner <br />Ter.ant -- — �-�— <br />fiGl 1 Bevcily b�vd <br />1.!an AOa�ess <br />610�I Atltlress <br />AMPED [�ccu�c E!vtecha�,cal LLC PU Bea 9G8 <br />Eieclncai Contractor �aad .�acress <br />AMPEDEM907CJC <br />State License Number Ireqwred) <br />��, Siny'c Fan��dy Rnsiticncc <br />� Proposed Use of Hw!d�ng <br />Square Footage (4 residenlial ner: consuccuon, remode'� or addd:on) <br />Number of devices (If low vouaye) <br />Desenpuon of Wod to Be Done �n,tall orcwis lor heat pump <br />Lvnfplt <br />City <br />Clty <br />CVQfP.0 <br />Crty <br />WA I 98203 425�355-948A <br />StalelZio <br />StateZo <br />PhOne <br />VhU�B <br />l"lAI9820b 425�SE3�641� <br />Stale/Z�.D Pnone <br />� C��71: <br />Gty of Evereti B�s�ness License Numner �requ,red) <br />Contracl Pnce ot Work <br />A4arUn S.+ty / 425�355�9CA8 <br />Contact PerSONContacl Num <br />FtE -� <br />CITY OF EVERETT LOCAL SALES TN( CODE IS J105 - �/.lI Q� <br />I hrrr.b}� c. ••dy fhaf I hove icad and exammeJ Ihis opNlrc.ihon and krrow fhe sarnc lo Ge bue and v <br />cnriect All provis�ons olld;vs and ordmances yoverninp fh�s type ol woiF wdl be rorrrplefed ---- - <br />�vhefher spcuhed Irerem or nof Th� granhny ol n pernv� docs rrot presume lo g�ve aufhw�ty fo PERMIT# <br />vro:afe oi cancei !he piovaions olany ofhrr sfafe or ro�al law regulahng conshuction oi the ��`/ ��, /� l, <br />pertoimance ol conshuchon Thaf / am aufhonled by fhe o�5nei ol fhis property fo periorm fhe r i � U <br />work /o� which aUP��cal�on is rnade and 1 comply �vdh Ihe Sfate Conhac/o�s La�v 78.27 RCW ond <br />296 ?00 lh'AC <br />� c-i 12124l201A <br />_. nnon. . �la.>n: r <br />Signatwe Dale <br />��lvd[DUN�a.:J� i <br />