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age: 2 of 2 02/3/2015 09:19 AM T0:14252578£357 FROM <br />E H3606591517 i <br />�— _ ---�- - <br />Kate Anderson <br />ELE^TRICAL 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 />4904 Ha�bc� Wne. Everett WA 98203 <br />PROJECT ADORESS <br />Nargaret Davasi 4904 HarborLane Everett <br />Owner <br />Ten::nt <br />A"8�I AtlOress <br />1.7eiI AdGress <br />Amped Eleetnc 6 Meehan�eal LLC PU Baz 868 <br />[lectr�cal Conifaclot Ltad Atldress <br />AMP[DfIJ�907�4 <br />State Ucense Number (required) <br />Singic Family Residencc <br />proposed Usc+ of Duilding <br />Square Foo�age QI residential ne�+� construction, remodel or addnion) <br />2 arcwts <br />Nurnber of devices Qf low volt, gc) <br />add crtcwts for existing heat sinp <br />Descnptwn of Work to 6e Done. <br />CITY OF EVERETT LOG1L SALES TAX CODE IS J105 <br />City <br />Ciry <br />Everett <br />Ciry <br />VJ�� �25 423 03t7 <br />St3le/Lp Phone <br />Stete2iD Phone <br />WA198206 <br />Slate/Zip <br />125-SD3-6a1a <br />Phone <br />#04�712 <br />City ot Everelt Business License Number (requved) <br />3300.00 <br />Contiacl Prlce ol Work <br />Andrcw SbpechlA25�583-6414 l. mpedemC�gma�i com <br />Contact PersonlContact Number�Email <br />I hereby ccrLly flraf 1 have read nnd examrned lhis applmahon and know fhe s2me to be lrue and <br />corred. All prov�s�ons o/ W�vs and ordmances govermng fh�s type o7 «�ork wil! Ge comple(ed <br />whether specrhed he�crn or nol. The granhng oi a pe�md docs nof presurne to g�ve aulhonty to <br />wolafe or cancel the provisions ol any other stafe or locallaw reculatino conshuction cr the <br />peAormance olconsbuUion That I am aufhonzed by fhe ownero/(h�s properiy fo perfoimlhe <br />�vwk /o� n-hich app6cation �s made and 1 comply ud(h fhe State Confraclors La�v 18.2� RCIN and <br />29G 200 W�C. <br />J�al< �.3.�..,��. L3�2015 <br />Siqnat��e Dale <br />ucwsen ca�a✓to,, <br />ree <br />�D °� <br />r�eRrnru <br />E i5oa -o� � <br />PH I <br />