1519 132ND ST SE DENTISTS OF MILL CREEK PACIFIC DENTAL 2019-08-20

ECTRICAL PERMIT A�LICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P) 425-257-8810 � FAX 425-257-8857 � (E) everetteps@everettwa.gov � www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 1 51 9 1 32f1d St SE BUILDING AREA(if residential, new construction, remodel, or addition)2.592 SF BUILDING TYPE: ❑ SFR-DETACHED ❑ SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: � COMMERCIAL usE oF Bui�oiN�: Commerical Tenant Space ELECXRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK:�$ 45,950 NUMBER OF DEVICES (if low voltage): FIRE ALARM? ❑YES � �1V0 ASSOCIATED BUILDING PERMIT# (if applicable): DESCRIPTION OF WORK: Remodel existing tenant space and relocate existing panel. CONTACT INFORMATION OWNER NAME: Algem II TENANT NAME(If Commercial): Pacific Dental Services OWNER MAILING ADDRESS: sTREEr 15815 NE 49th St cirv Redmond sTATF WA iiF> 98052 OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: Kirby Electric Inc. CONTRACTOR ADDRESS: sTREET 4826 B St NW#1 O1 ci�, Auburn srA�t WA Tir 98001 CONTRACTOR PHONE: 253-859-2000 CONTRACTOR EMAIL: vadimk�a kirbyelectric.com � CONTRACTOR LIC.#(REQUIRED): KIRBYE1077BN CITY OF EVERETT BUSINESS LIC.#(REQUIR�D): 041 110 , PRIMARY CONTACT: ❑ OWNER � CONTRACTOR ❑ OTHER(Please Specify) __ _ _ CONTACT NAME: CONTACT PHONE: 253-859 2000 �- Vadim Kalchik CONTACT EMAIL: vadimk@kirbyelectric.com AGREEMENT I hereby certify that I have read and exarnined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type o(work will be completed whether specified herein or not. The granting of a permit does not presiune to give authority to violate or cancel the provisions ol 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 o(Everelt O((icial Use Onty PERMIT# , � � E �� - t �5 : � z � OwnerlAuthorize�ent Signature Date (Revised 9/23/2016)