11419 19TH AVE SE SILVER LAKE ACUPUNCTURE 2019-06-11

4:77. 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 I www.everettwa.gov/permits l o PROJECT ADDRESS. " - _ _ - —_� . // 4 / i c e-h Ave- BUILDING AREA(if residential,new construction,remodel,or addition) SF BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL USE OF BUILDING: Store --A c^' =P `r:t~Fx kvii i`: �a��. �'�.+ CONTRACT PRICE OF WORK: $ 2,500.00 NUMBER OF DEVICES(if low voltage): FIRE ALARM? 0 YES 0 NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: Install (5) New branch circuits .}� 'I ? -3aiiw {.' +' „ �11A1 P< �T _ ASATI garL�H f tF aEt ttU .a OWNER NAME: TENANT NAME(If Commercial):Alex Chun OWNER MAILING ADDRESS: STREET-42 1 le VE, /1 el' /9-617 O"P✓ 5C-: CITY Evertt STATE WA ZIP 98201 OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: Hertz Electric CONTRACTOR ADDRESS: STREET 757 116th Street South cm,Tacoma �y STATE WA ZIP 98444 CONTRACTOR PHONE: (2-06) z. qC—g a la CONTRACTOR EMAIL: CONTRACTOR LIC.#(REQUIRED) H E TZ E g o3 Ki CITY OF EVERETT BUSINESS LIC.#(REQUIRED) 5- 337 PRIMARY CONTACT: ❑OWNER ,CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: (253)g2.0 S 100 Chong Kim 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# , E ( Sof -- ( . Owner/Authorized Agent Signature Date (Revised 9/23/2016)