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age: 3 of 3 OE3/7i2015 12 : 00 PM T0: 1425'7_57F3�57 PftOM: Kate Anderson PH <br /> E q3606914517 <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 �` 1� _'� <br /> r� S��� sZ <br /> 2019 Wetmorc Ave. Evcrett WA 98201 <br /> PROJECT ADDRESS <br /> Beth Kuykendal� 2019 WeUnore Ave Everetl WA, 98201 509-209-3677 <br /> O�.vner Mail Add�ess C�ty S1a1c/Zip P�onc <br /> TenaN M1fait Address City StalelZ�p Phonc <br /> Amped Electric R Mechaniwl LLC PO Box 868 F�,.��ii WAI98206 425�SA3�6414 <br /> Eleclncal Con�rac�or ldal Adtlress Gty State/Zip Phone <br /> AMPEDCM907D4 �'048712 <br /> Slale License Number(reqmred) City of Everelt L3usiness License Number(requiied) <br /> S�nqle Family Re,idence 5300.00 <br /> Proposed Vse o�Outldmg Conlract Pnce ol Work <br /> pntlrew SLpechlA25•563•6414��rdy(��ampcdcleclnUlc. om <br /> Squaie Footage(If residenual new construdion, remodel or adddion) Contact PersonlConlact NumbedLmail <br /> Number ol derices pl lov+voltage) <br /> add Nro arcuits for tuinnr.n <br /> Ueseriptiun o(Wo�k to�c Donr <br /> 'EE nh <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 ��� w� <br /> i <br /> I hcrebp tcrtdy Ihnl l havc rcad and exanrmeJlh�s a?phcahon and know fhe samr. to be fnie and <br /> conecf AI;prows�ons ollaws arrd ordinances�ovr,rnrno lhis fypc ol wmk wdl be complefed -- ---- <br /> whelhe�spec�hed he�em or nnl. ilre granhny of a pennil Jocs nof presume 10 grvr. aulhontylo PERh11T# <br /> wolale or canre!lhe pro�vs�ons o/any olher sfa(e o�lor,�l law requlahng construclion orlhe ^ � �O�� D�� <br /> perlorrnance o7 conslrucGon That I am authorized by fhe onner o/fhis property to pe�}orm Ihe t <br /> work !or whrch applicnl�on rs made and I comply�vdh Ihe Stale Conlracfors Lmv 10 77 RCW and <br /> 796 200 WAC. ---- <br /> �.d� ('I���k,no., 0l3�1�7015 <br /> Siyn�Wrc Ualc <br /> „�vcd nonrar.vt. <br />