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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 � FAX 425-257-8857 � (E)everetteps@everettwa.gov� www.everettwa.gov/permits <br /> `�3.� x ���.��R ��s"`�rr"� .�,:_: �?�� ��t <br /> w.s � �:��,�• �����x <br /> PROJECT ADDRESS: �4�� r'JOtII St S E <br /> BUILDING AREA(if residential, new construction, remodel,or addition) SF <br /> BUILDING TYPE: m SFR-DETACHED ❑SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL <br /> USE OF BUILDING: �@SIC�@t1CC,' <br /> .�� <br /> , <br /> CONTRACT PRICE OF WORK: 300.00 <br /> NUMBER OF DEVICES if low Ita e : <br /> FIRE ALARM? ❑YES �NO <br /> ASSOCIATED BUILDING PERM licable : <br /> DESCRIPTION OF WORK: Gas FAU extentions from exting circuit to new FAU location <br /> ..,,. � F ... .-:;.,. y �., . ,. , �,,,r„.-�,--,,,, � . \ ..'. <br /> �,��.a �� �\ f� �r7�$z �� ��� � � �� <br /> ^.c.. � c�, / r,� + ,.� `�� �`=� �%,, <br /> OWNER NAME: BIII MCCuIIaCh TENANT NAME If Commercial : <br /> OWNER MAILING ADDRESS: sTReer 1411 150st SE <br /> �,T„ Everett STATE H/a ziP 98203 <br /> OWNER PHONE: 2069992912 OWNER EMAIL: <br /> coNrwacTOR Nanne: Amped Electric&Mechanical LLC <br /> CONTRACTOR ADDRESS: sTReer PO BOX S6H <br /> c,Tv Everett WA STATE WA zia 982 <br /> CONTRACTOR PHONE: 360 294 8276 CONTRACTOR EMAIL: MII(@W p�aCTlpeCleleCtC'ICIIC.COPYI <br /> coNrRacTort uc.#�REQuiREo�: AMPEDEM907D4 CITY OF EVERETT BUSINESS LIC.#(REQUIRE �: 049712 <br /> PRIMARY CONTACT: ❑OWNER �CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 206 724 1188 <br /> Mlke Wa�kel" CONTACT EMAIL: Mlk@W@aPTlp@d@I@CtPICIIC.COCTI <br /> AGREEMENT.�!hereby certify that I have read and examined this application and know the same to be true and correck All provisions of/aws and ordinances goveming this type <br /> of work will be completed whether specified herein or not The granting of a permit does not presume to give authority to vio/ate or cance/the provisions of any other state or <br /> local law regu/ating construction or the performance of construction. That/am authorized by the owner of this property to perform the work for which application is made and 1 <br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAC. <br /> City of Everett O�cial Use On/y <br /> PERMIT# <br /> �w�- 11 -17-17 E l�-� ` -- l�s <br /> Owner/Authorized Agent Signature Date (Revised 9l23/2016) <br />