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ELECTRICAL PERMIT APPLICATION <br /> Ie►', CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 1 (E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> PROJECT:SITEr1M FO IATION* • <br /> PROJECT ADDRESS:3607 Federal Ave. SE Everett, WA 98201 <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: 0 COMMERCIAL <br /> USE OF BUILDING: Residence <br /> ELECTRICAL APPLICATIO.N.UNFORMATION;: <br /> CONTRACT PRICE OF WORK:$ 850 <br /> NUMBER OF DEVICES(if low voltage): <br /> FIRE ALARM? 0 YES 0 NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: Install Power for Heat pump and Air handler <br /> CONTACT INFORMATION <br /> OWNER NAME:Mike Burghoff TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 3607 Federal Ave. SE <br /> cm. Everett STATE WA zip 98201 <br /> OWNER PHONE: 269-806-7123 OWNER EMAIL: <br /> CONTRACTOR NAME: Rhema Electric <br /> CONTRACTOR ADDRESS: sTREET 628 S. Spruce St. <br /> crn Burlington STATE WA zw 98233 <br /> CONTRACTOR PHONE: 360416-8227 CONTRACTOR EMAIL: davea@rhemaelectric.com <br /> CONTRACTOR LIC.#(REQUIRED): RHEMAEL940DH CITY OF EVERETT BUSINESS LIC.#(REQUIRED):45783 <br /> PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 360-391-1884 <br /> Dave AIaniz CONTACT EMAIL:davea@rhemaelectric.com <br /> AGREEMENT:I hereby certify that I have reed and examined this application and know the same to be true and correct All provisions of laws and ordinances governing this type <br /> of work will be completed whether specified herein or not. The granting of a pentdt does not presume to give authority to violate or cancel the provisions of any other state or <br /> local law regulating construction or the performance of constwction. That lam authorized by the owner of this property to perform the work for which application is made and I <br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> ' PERMIT# <br /> 08 E 1St - t+( <br /> Owns uth razed Agent Signa Date (Revised 9/23/2016) <br />