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a�e : 2 of 2 07/ 10/2015 08 : 73 At4 T0 : 14252578857 FROM : Kate Anderson P <br /> �E W3606914517 <br /> ELECTRI�AL PERMIT APPLICATION � <br /> CITY OF EVERETT PERMIT SERVICES III <br /> 3200 CEDAR STREET, EVERETT, WA 98201 �, <br /> 425-257-8810 - FAX 425-257-8857 —v✓vn+� everettwaorg i <br /> I <br /> -7--I���S I <br /> C iSo� � <br /> ,fiz�;ae�r, s,�„�•� sE � 6 <br /> PROJECT ADDRESS I <br /> Mary Roliins 1626 461h St SE Everett U/A 98203 <br /> O•.+ner G1ad Atldres, Gry Stetei2i; Phonc <br /> Tenant h1ai�Address City State/ZiD Phone <br /> Amped Eleetnr. E 'dn�hanicai lLC PO Box 86� Everwtt N'N95206 425-583�6h1 a <br /> EIBCtfl�al ConV2C�Ot h'eil ACd�e55 Qry Slale2!p Phonc <br /> AMPEDEPn907D4 k048712 I <br /> Slate License Number(required) City af Everett Business License Number IreGwred) I <br /> I <br /> 5300.00 � <br /> � S�nGle Furi�� Rn���cncc <br /> i Proposed Use ol 8uilding Contract Price of Work I <br /> Andrew StipeclilJ25-593�6A141andyL'ampedelecincllc c��m <br /> ' �quare �oota9e (If residenUal new construcUon, remod�l or adddion) Con�act PersoniContact NumbeUEmail <br /> I <br /> Number of devices(If lo�voltage) I <br /> Iadd two arcwls(or fumacc <br /> � �escnphon o(Work�o E3e Done <br /> I <br /> I� — FEE <br /> ICITY OF EVERETT LOCAL SALES TAX CODE IS 3105 �G� W <br /> �LJ . � <br /> 1 hereby cerh/y thel l have reod and examined 7his applrcalion and know fhr. sarne to be hue and <br /> correcf All prov�sions ollaws and ordmances governmg(his fype ol work wdl be compleled — <br /> whetl�er speciGed'nerein or not. The gran6ng oI a permrt does iwf presume(o give aufhority to P[khllTk <br /> vio/afe or cancel the prowsions o(any olher slafe or local law requlabng construchnn or the / <br /> peAormance o/consfrucfion (haf!am authonzed by fhe owner of fh�s property fo peAomi the E lv�O� � �j� <br /> woik!oi wh�ch applrcahon�s made and I comply wdh Ihe Sta(e Contiactors Law 18.27 RCW and J v <br /> 296 200 :NAC <br /> `.K.,r< lY:�d..�.,.. 7 to�2ot5 <br /> Signatwc Uate <br /> REN&=POHib?uid . �._ _ � � _ � � <br />