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

ELECTRICAL PERMIT APPLICATION AbidiliT:"—A CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 1 FAX 425-257-8857 1 (E)everetteps@everettwa.gov 1 www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 11419 19th Ave SE -C106 BUILDING AREA(if residential,new construction,remodel,or addition)4100 SF BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL USE OF BUILDING: dental clinic ELECT 'ICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK.$ 1800 NUMBER OF DEVICES (if low voltage): 2 FIRE ALARM? 21 YES 0 • 0 ASSOCIATED BUILDING PER • • applicable): DESCRIPTION OF WORK: Relocating 1 audio/visual device and adding 1 smoke detector to existing fire alarm system. CONTACT INFORMATION OWNER NAME: Washington Building Supplies TENANT NAME(If Commercial): Silverlake Clinic OWNER MAILING ADDRESS: STREET 11419 19th Ave SE, C106 c,,., Everett STATE WA ZIP 98208 OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: Western States Fire Protection CONTRACTOR ADDRESS: STREET 14690 NE 95th ST#101 cm, Redmond STATE WA ZIP 98052 CONTRACTOR PHONE: 425-881-0100 CONTRACTOR EMAIL: seth.zehnder@wsfp.us CONTRACTOR LIC.#(REQUIRED): WESTESF906P1 CITY OF EVERETT BUSINESS LIC.#(REQUI-' 9): Zb JS PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 425-478-9709 Seth Zehnder CONTACT EMAIL: seth.zehnder@wsfp.us 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# idi .C., E �9 c -\2� Owner/Authorize. A.-nt ignature Date (Revised 9/23/2016)