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age: 2 of 2 07/14/2015 12:21 PM 70: 14252578857 FROM : Kate Anderson P <br /> NE 03606914517 <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 /> 1106 59th PL SW, Everett WA 98203 -7 —U—15 <br /> PROJECT ADDRESS <br /> Emily Woods 1106 59th PL SW Everett WA 98203 425.501.3277 <br /> Owner Mail Address City Statelzip Phone <br /> Tenant Mail Address City StateRiP Phone <br /> Amped Electric R Mechanical LLC PO Box 868 Everett WA/98206 425.583.6414 <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> AMPEDEM907D4 $048712 <br /> State License Number(required) City of Everett Business License Number(required) <br /> Single Family Residence $300.00 <br /> Proposed Use of Building Contract Price of Work <br /> Andrew Stipech1425.583-6414 landy©ampedeleclricltc. <br /> Square Footage(lf 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 /> FEC — - -- <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 �O DD <br /> I hereby certify that I have reed and examined this application and know the same to be true and <br /> correct All prowsrons of lews and ordinance s governing thl,type of work will be completed <br /> whether specdied herein or not. The granting v1 a r:armu roes not presume to give authorityto PERMIT# <br /> violate or cancel the provisions of any other state or local law regulahng coastruchoi,or the <br /> performance of construction That I am authonzed by the owner of this property to perform the <br /> work for which application is made and I comply with the Stele Contractors Law 18.27 RCN and w� <br /> 298200 WAC. <br /> `41. &ae.a 7.142015 <br /> Signature Date <br /> nevrsinoam-nor. <br />