6732 BEVERLY BLVD 2018-01-05 - Laserfiche WebLink

� � ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 � FAX 425-257-8857 � (E) everetteps@everettwa.gov � www.everettwa.gov/permits '' PROJECT'SITE'INFORMAT'ION '' PROJECT ADDRESS: 6�T32 BeVerl B�VC�. BUILDING AREA(if residential,new construction,remodel,or addition) SF BUILDING TYPE: ❑ SFR-DETACHED ❑ SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL USE OF BUILDING: COrll@r rocer store ` ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ 700.00 NUMBER OF DEVICES (if low volta e): FIRE ALARM? ❑YES 0 NO ASSOCIATED BUILDING PERMIT# if ap licable : �escRiPTioN oF woRK: Electrical for Ductless heat pump 1- 20A 120V and 1- 20A 220V circuit CONTACT INFORMATION ' OWNER NAME: AI GOSIaI( TENANT NAME(If Commercial): OWNER MAILING ADDRESS: sTReer 6732 Beverty Blvd. CRy Eevertt STATE ••,` ZIP 98203 owNeR PHONE: 206-525-6969 OWNER EMAIL: CONTRACTOR NAME: Rfl@flla EIGCtCIC, LLC CONTRACTORADDRESS: sTaeer628 S. Spruce St �R,. Burlington STATE WA Z�P 98233 CONTRACTOR PHONE: 3GO-4'I6-HZ27 CONTRACTOR EMAIL: CJaVea@C'I12t71a@I2CtCIC.COt71 CONTRACTOR LIC.#(REQUIRED): Rh2CT18eI294OCII1 CITY OF EVERETT BUSINESS LIC.#(REQUIRED):45783 PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 36�-3Q�-�$$4 Dave Alaniz coNTacT eMai�:davea@rhemaelectric.com AGREEMENT:1 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 rype of work will be comp/eted 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 1 am authonzed 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# J t �� E ��1 I I ' I 0�1 wn /Authorized Ag nt Signature Date (Revised 9/23/2016)