11220 19TH DR SE 2017-10-25 - Laserfiche WebLink

ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES 04�= 3200 CEDAR STREET, EVERETT, WA 98201 (P) 425-257-8810 1 FAX 425-257-8857 1 (E) everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 11220 1 9th Dr SE BUILDING AREA(if residential, new construction, remodel, or addition) SF BUILDING TYPE: ❑ SFR-DETACHED 0 SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: ❑ COMMERCIAL USE OF BUILDING: Residential ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ 600 NUMBER OF DEVICES(if low voltage): FIRE ALARM? ❑YES 0 NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: Add circuit for retrofit heat pump Install CONTACT INFORMATION OWNER NAME:Mary Nichols TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET 11220 19th Dr SE 11TV Everett STATE WA ZIP 98208 OWNER PHONE: (206)459-2751 OWNER EMAIL: CONTRACTOR NAME: Bob's Heating & Air Conditioning CONTRACTOR ADDRESS: STREET 14148 NE 190th St I,TY Woodinville STATE WA ZIP 98072 CONTRACTOR PHONE: 800-840-3346 CONTRACTOR EMAIL: echaU@bobsheating.com CONTRACTOR LIC.#(REQUIRED): BOBSHHA85ONJ ICITY OF EVERETT BUSINESS LIC.#(REQUIRED):054967 PRIMARY CONTACT: 0 OWNER ❑ CONTRACTOR ❑ OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: (206)459-27.551 Mary Nichols CONTACT EMAIL: AGREEMENT.I 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 I 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 PERMIT# -71 Owner/Autho,ized Agent Signature Date (Revised 9/23/2016)