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a(;e: 2 of 2 l0/23/2014 13:4t PM T0:1425'2578II57 i'ROM: Donna Barner PH <br />E tt2064915506 _� <br />� � � <br />ELECTRiCAL PEaMIT APPLICATION <br />2808 18th Strect SE <br />PROJECT ADDRESS <br />MelOdy Scaizo <br />Owner <br />Tenant <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 />2B08 181h Street SE <br />Mea Adtlress <br />Moil Adtlress <br />Amped [leclnc & Mechanical llC PO Box 868 <br />[leclrical COnlraGtor Moil Adtlress <br />Afv1P[DEM907U4 <br />State License Number (required) <br />Single Family Residence <br />Proposed Use of Building <br />Square Footage (If reSideNial new construchon, remodel or addition) <br />Number of devices (I( lovi voltage) <br />Fverel� <br />City <br />Cify <br />Everen <br />City <br />Description of Work to Be Done: In;tall arcun;_for dualos�: he�d pun�_ <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />WAI9�201 <br />I b � a3��`� <br />��y��-�5-d <br />Slate/Zip <br />State/Zip <br />WAI98206 <br />StalclZtp <br />425-339-�a40 <br />Phone <br />Phonc <br />425�583�6414 <br />Phone <br />H04�712 <br />Cily of Everell Business License Number (required) <br />Conlracl Price of Work <br />Melody Scalzo I A25�339��440 <br />Contact PersonlContact NumberlEmail <br />I hereby cc�fily lhof I havc read and exammed lhis appl�cahon and know the same lo be hue and <br />correcf �ll provisions of laws ond ordinances gnverning fhis type o/ work wdl be complefed <br />whefher speuhed lierein or nof. Thr. granf�ng o! a peimrl does no( presume fo givo aufho�ity lo <br />v�oiule or cancel fhe provisions ol any olhci slate or local law �eoulafing consfruc6on o� the <br />pe�lormance ol consfiuc6on Thaf I am au(honzed by Ihe oivner ol this p�operty (o perform the <br />�vork !or which apphcahon is made and 1 compty wdh the Slale Conbaclors Law 78.27 RCW and <br />796.200 WAC. <br />�D�„�.�.� tJ}u„�., <br />ia vr:i � nnn,u,�in a <br />10/23/201 A <br />FEE ----- <br />.- <br />�� <br />P[RMIT# <br />E��(0-�5� <br />