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ellii ELECTRICAL PERMIT APPLICATI , <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 JAN <br /> (P) 425-257-8810 I FAX 425-257-8857 I (E) everetteps@everettwa.gov ermits <br /> 9 www.everettwa.gov/permits <br /> 9 <br /> M;••'��ii,l�i�'�a�t �,5r x�ri��UB�,ir�'���7'n ��y� ' „TS-i I �ai�� _a�a� rn s. __ i�.;� =u;:� i i�, u�� .;�ej ii� dI �� �4N v.�!i r �. s ,L"' h�.�. :""�t"nyr, <br /> Grp ; Hyl - , OJECT SITE INFO NATION ° . . <br /> PROJECT ADDRESS: 10932 PAINE FIELD WAY <br /> BUILDING AREA(if residential,new construction, remodel,or addition) 2183 SF <br /> BUILDING TYPE: X SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: RESIDENTIAL • <br /> ' '.- ���xr'n in �: i N����. * �i i n�;P.. a jai i Q i i i <br /> vii �4� �Ni K.';:- t �ti�ji iii ��, k. him i� ^+g p� h�n' r' iifr t „v <br /> 1 x>, **.0401 k#0•4104: 0:0100,000:"'ION k �i �:=� z ',u „'ryi <br /> '�� �,.� 6i�...��� sn� ti,�•u° I�r, ri 4i inni�..��e , +G iai usd a „�iyi�w'��y�'L � i' .iu,�� �� �-,�. <br /> CONTRACT PRICE OF WORK: $ 600.00 <br /> NUMBER OF DEVICES (if low voltage): <br /> FIRE ALARM? 0 YES : DIE NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: INSTALL CIRCUIT FOR 2 ZONE DUCTLESS HEAT PUMP INSTALLATION <br /> `CONTACT INFORMATION =q <br /> OWNER NAME: RICK& KAREN SISTEK TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 2143 W 4TH ST <br /> CITY PORT ANGELES STATE WA. zip 98363 <br /> OWNER PHONE:360-452-7471 OWNER EMAIL: <br /> CONTRACTOR NAME: BLUE FLAME HEATING&AIR CONDITIONING <br /> CONTRACTOR ADDRESS: STREET 7116 220TH ST SW,#1 <br /> CITY MOUNTLAKE TERRACE STATE WA ZIP 98043 <br /> CONTRACTOR PHONE:425-771-7139 CONTRACTOR EMAIL:INFO@BLUEFLAMECOMFORT.COM <br /> CONTRACTOR LIC.#(REQUIRED): BLUEFFH845QA CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 052790 <br /> PRIMARY CONTACT: 0 OWNER IXCONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 425-771-7139 <br /> NAQUIN GRAY CONTACT EMAIL: INFO@BLUEFLAMECOMFORT.COM <br /> AGREEMENT:T 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 <br /> 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 <br /> 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 <br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> FEE <br /> lb 16 0°.1 <br /> PERMIT# <br /> 1( . : <br /> 5/8/17 E rt 05— ()U'1 <br /> Owner/A ized A‘,{7/ <br /> Date (Revised 10/12/2015) <br />