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4r4-17 ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 I (E) everetteps@everettwa.gov I www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: 1 1 102 20th Dr SE <br /> BUILDING AREA(if residential,new construction,remodel,or addition) SF <br /> BUILDING TYPE: El SFR-DETACHED Ii(SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: Residential <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK: $ 600 <br /> NUMBER OF DEVICES(if low voltage): <br /> FIRE ALARM? 0 YES EI NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: Add circuit for retrofit heat pump install <br /> CONTACT INFORMATION <br /> OWNER NAME:Ruben Muniz TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 11102 20th Dr SE <br /> cm, Everett STATE WA ZIP 98208 <br /> OWNER PHONE: (206)250-8355 OWNER EMAIL: <br /> CONTRACTOR NAME: Bob's Heating & Air Conditioning <br /> CONTRACTOR ADDRESS: STREET 14148 NE 190th St <br /> CITY Woodinville STATE WA ZIP 98072 <br /> CONTRACTOR PHONE:800-840-3346 CONTRACTOR EMAIL: echau@bobsheating.com <br /> CONTRACTOR LIC.#(REQUIRED): BOBSHHA85ONJ CITY OF EVERETT BUSINESS LIC.#(REQUIRED):054967 <br /> PRIMARY CONTACT: fa OWNER 0 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: (206)250-8355 <br /> Ruben Muniz CONTACT EMAIL: <br /> 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 <br /> 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 /> j` PERMIT# <br /> * <br /> '2-1 11 E t s-"1 o +1 — e(4-8 <br /> Owner/Authorized =- ignature Date (Revised 9/23/2016) <br />