12728 19TH AVE SE DR MARK STIVERS 2019-06-11

OIL ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P) 425-257-8810 FAX 425-257-8857 (E) everetteps©everettwa.gov I www.everettwa.gov/permits ctJ-Fn 411434W- SITE INFORMATION PROJECT ADDRESS: 12728-Bothell-Everett Highway suite 109-Everett, WA 98208 BUILDING AREA(if residential, new construction, remodel, or addition) remodel SF2440 BUILDING TYPE: El SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL USE OF BUILDING: Dental Clinic .( ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK/$ 34,790 NUMBER OF DEVICES (if low voltage): FIRE ALARM? ❑YES ' 0 NO ASSOCIATED BUILDING PERMIT# (if applicable): DESCRIPTION OF WORK: tenant improvement of an existing core and shell space. New led lights, new outlets, new switches. exiting panel and circuits. CONTACT INFORMATION OWNER NAME: Winston Lessley TENANT NAME(If Commercial): Dr Mark Stivers DDS OWNER MAILING ADDRESS: STREET 10511 19th Ave SE Suite C Everett, WA 98208 CITY STATE ZIP OWNER PHONE: 425 379 2844 OWNER EMAIL: winstonlessley@gmail.com CONTRACTOR NAME: Lunstrum Electric Inc. CONTRACTOR ADDRESS: STREET 15372 juanita dr ne CITY ken more STATE wa ZIP 9728 \ CONTRACTOR PHONE: 2069300057 CONTRACTOR EMAIL: lunstrumelectric@gmail.com CONTRACTOR LIC.#(REQUIRED): LUNSTEI882NH CITY OF EVERETT BUSINESS LIC.#(REQUIRED)': 53442 PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 206 930 0057 Peter Lunstrum CONTACT EMAIL: Iunstrumelectric@gmail.com 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. r r 12/26/17 City of Everett Official Use Only PERMIT# E RA2 - 15t Owner/Authorized Agent Signature Date (Revised 9/23/2016)