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:,t1,,,c16') <br /> ,1111°P ELECTRICAL PERMIT APPLICATION <br /> �r CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREE ', EVERETT,WA 98201 <br /> (P)425-257-8810 i FAX 425-257-8857 I(E)everetteps@everettwa.gov i www.everettwagov/perrnits <br /> "lilnk \., gViti C I4 R04,0 tt4 4t E \i 6re�y;;F. <br /> PROJECT ADDRESS: 1300 44th St SE Everett WA <br /> BUILDING AREA(if residential,new construction,remodel,or addition) SF <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 10 COMMERCIAL <br /> USE OF BUILDING: <br /> � n ,f ' :Ec AICAtPnpP�.1c0�r� i FORM T$QN -i4 <br /> tea,,, ., £�» .�.� .� „_ ,„ Y. ,,,.,,,,tom,„x, . � ,r� ,. �& a w rte... w <br /> CONTRACT PRICE OF WORK:$ 200.00 <br /> NUMBER OF DEVICES(if voltage): <br /> FIRE ALARM? 0 YES 0 NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: Connect replacement heatpump <br /> tip., ,, CCIN,TAC'r iNpoRMATIoN { A <br /> OWNER NAME: TENANT NAME(If Commercial):Cornerstone Prosthetics <br /> OWNER MAILING ADDRESS: STREET 1300 44th St SE <br /> cm,Everett, WA STATE WA. ZIP 98203 <br /> OWNER PHONE: 425-339-2559 OWNER EMAIL: <br /> CONTRACTOR NAME: Rhema Electric <br /> CONTRACTOR ADDRESS: STREET628 S Spruce ST <br /> cm/Burlington STATE WA zip 98233 <br /> CONTRACTOR PHONE:360-630-0164 CONTRACTOR EMAIL: daveb@rhemaelectric.com <br /> CONTRACTOR LIC, (REQUIRED): RHEMAEL940DH CITY OF EVERETT BUSINESS LIC.#(REQUIRE[):45783 <br /> PRIMARY CONTACT: El OWNER ®CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 360-630-0164 <br /> David BUben CONTACT EMAIL:daveb rhemaelectric.com <br /> AGREEMENT:I hereby certify that I have teed and examined this application and know the same to he true and collect, AP provisions of laws and ordinances governing this type <br /> of work will Ite completed whether specified herein or not. The granting of:a permit droes not presume to giveauthority to violate or cancel the provisions of any other state or <br /> local Jew regulating construction or the performance of construction. That't am authorized by the owner of this property to perform the work for which application,is made and d <br /> comply with the State Contractors Law 16.27 RCW and 298.200 WAC.. <br /> City of Everett Official Ilse Only <br /> PERMIT# <br /> IL4 <br /> E t 561c -- 1S3 <br /> *vtner/Auuthorized Agent SI: =t a Date (Revised 9/2312016) <br />