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Z8-Dec-2016 05:54 From Kate Aiv1Prson. Phone #3602948276 FaxZero.com p.2 <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 /> 1910 Jackson Ave, Everett WA <br /> PROJECT ADDRESS <br /> Donny Shove 1910 Jackson Ave Everett WA/98203 425-268-5936 <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> Amped Electric& Mechanical LLC PO Box 868 Everett WA/98206 425-583-6414 <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> AM PEDEM907D4 #048712 <br /> State License Number (required) City of Everett Business License Number(required) <br /> Single Family Residence 450.00 <br /> Proposed Use of Building Contract Price of Work <br /> Mike Walker/206-724-1188/info©ampedelectricllc.corn <br /> Square Footage(If residential new construction, remodel or addition) Contact Person/Contact Number/Email <br /> Number of devices (If low voltage) <br /> add two circuits for furnace <br /> Description of Work to Be Done: <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 __. <br /> I hereby certify that l have read and examined this application and know the same to be true and <br /> correct. All provisions of laws and ordinances governing this type of work will be completed <br /> whether specified herein or not. The granting of a permit does not presume to give authority to PERM I T# r <br /> violate or cancel the provisions of any other state or local law regulating construction or the �r _ ( L <br /> performance of construction. That I am authorized by the owner of this property to perform theE "� <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> 12-27-2016 <br /> Signature Date <br /> REVISED 08/06/2014 <br />