4920 RUCKER AVE 2017-09-22 - Laserfiche WebLink

17-Aug-2017 03:53 From Mike Walker. Phone #Z067241188 FaxZero.com p.2 0 0 ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES OL 3200 CEDAR STREET, EVERETT, WA 98201 (P) 425-257-8810 FAX 425-257-8857 1 (E) everetteps@everettwa.gov www.everettwa.gov/permits „PROJGT17NFQRC><#Did PROJECT ADDRESS: 4920 Rucker Ave BUILDING AREA(if residential, new construction, remodel, or addition) SF BUILDING TYPE: ❑SFR-DETACHED SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: ❑ COMMERCIAL [USE OF BUILDING: residence NFQRPS "1GAT10E CONTRACT PRICE OF WORK: 1000.00 NUMBER OF DEVICES (if low voltage): FIRE ALARM? ❑YES O ASSOCIATED BUILDING PERMIT# (if applicable): DESCRIPTION OF WORK: Add new circuit for kitchen lighting and over head fan. ...... ................. ..... . . . CONTACT INFORMATION OWNER NAME: TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET CI(y SIAIE ZIP OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: Amped Electric and Mechanincal LLC CONTRACTOR ADDRESS: STREET PO BOX 868 ciTy Everett STATE WA ZIP 98206 CONTRACTOR PHONE: 360-294-8276 CONTRACTOR EMAIL: info@ampedelectricllc.com CONTRACTOR LIC.#(REQUIRED): AMPEDEM907D4 CITY OF EVERETT BUSINESS LIC.#(REQUIRED):048712 PRIMARY CONTACT: ❑OWNER EXCONTRACTOR ❑OTHER (Please Specify) CONTACT NAME: CONTACT PHONE: 360-294-8276 Amped Electric CONTACT EMAIL: info@ampedelectricllc.com AGREEMENT:T hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be completed whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction. That l am authorized by the owner of this property to perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only FEE PERMIT# 8/16/17 E i — 1 2.1 Owner/Authorized Agent Signature Daie (Revised 10/12/2015)