10810 19TH AVE SE 2019-06-11 - Laserfiche WebLink

4rETT ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 I FAX 425-257-8857 1 (E) everetteps@everettwa.gov 1 www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 10810 19th ave SE Everett WA BUILDING AREA(if residential,new construction,remodel,or addition) SF BUILDING TYPE: ©SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: ®COMMERCIAL USE OF BUILDING: Dental office ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ 400.00 NUMBER OF DEVICES(if low voltage): FIRE ALARM? 0 YES 0 NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: Disconect and reconnect HVAC unit CONTACT INFORMATION OWNER NAME: TENANT NAME(If Commercial):Silver Lake Dental OWNER MAILING ADDRESS: STREET 10810 19th Ave SE tT Everett. STATE WA z,p 98208 OWNER PHONE: 426-337-3000 OWNER EMAIL: CONTRACTOR NAME: Rhema Electric CONTRACTOR ADDRESS: STREET 628 S Spruce Street c„,. Burlington STATE WA ,eta 98233 CONTRACTOR PHONE: 360-416-8227 CONTRACTOR EMAIL: daveb©rhemaelectric,com CONTRACTOR LIC.#(REQUIRED): RHEMAEL940DH CITY OF EVERETT BUSINESS LIC.#(REQUIRED):45783 PRIMARY CONTACT: 0 OWNER CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 360-630-0164 Dave Buben CONTACT EMAIL:daveb@rhemaelectric.com AGREEMENTI hereby certify that l 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# / /mu . 1 *--.‘" /19 E -0E9 Owner/Authorized Agent Signature Date (Revised 9/23/2016)