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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 • FAX 425-257-8(i57 —www.everettwa.org <br /> 11802 EvergrPen VVay #104 Everett WA <br /> PROJECT ADDRESS <br /> Owner �dail Adtlress City Slate2ip Phone <br /> Dr Webly <br /> Tenanl �.1all Address C�ty Siale2ip Pnone <br /> Lunstrum Electric 15372 Juanita Dr NE Kenmore WA 98028 206-930-0057 <br /> I Eledrical Comractor hlail Atldress C�ty Slate2ip P�one <br /> LUNSTE1882NH _ S1S976 <br /> State License Number Contren Pnce ot Work <br /> Dental Clinic non surqical Peter Lunstrum <br /> IProposetl Use ol Butldmg Contact Person (Plan Rev�ew) <br /> I 1900 <br /> Square Footage(It res�denhal new cunstruaion, remodel or adddion) <br /> Mum6er of devices(II Iow voltage) <br /> oe5«�Puo��iwo�kcoeeuo�e Instillaiion of 20 2x4 troffers 35 flourecent can liqhts 11 mini <br /> can lights, 20 switches,64 outlets <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS J705 3 g�, 7c <br /> i <br /> 1 hereby certdy that 1 have mad and exornined(his applicafion anU know tbe same to Ge Irue and <br /> correct Al!provisruns ol laws and ordinances goveming this type ol work will be cornpleted <br /> whethe�specfied herein or no( The granling ol a permit does not presume to give authonty to PERMIT# <br /> violate or cancel fhe provisrons ol any other state or local/aw mgulafing consWction orlhe r I�O� _I�� <br /> pedonnance ol cons(n�cfioa Thaf f am aufbonzed by the owner o/fhis property to peAonn fhe t <br /> wo�k(or which appGca6on is made and I comply�+•ifh fhc Stato Cont2ctors Law iH 27 RCW and <br /> 296.200 WAG. <br /> Pa��. .�"".�t-'.".�'L 6/24/14 <br /> S�gnature Dale <br /> r.eviseo nau <br />