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grr ELECTRICAL PERMIT APFILICATION <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 /> II JI T SITE-I NFOR I/ IIO <br /> PROJECT ADDRESS:4806 Seahurst Ave. Everett, wa 98203 <br /> BUILDING AREA(if residential,new construction,remodel,or addition)3000 SF <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: It's a single family residence <br /> LOC ICAL APPLUCATIONNFORMATitdN <br /> CONTRACT PRICE OF W e 'K:$ 3000 <br /> NUMBER OF DEVICES f low voltage): <br /> FIRE ALARM? • YES NO <br /> ASSOCIATED BUILDING . - #(if applicable): <br /> DESCRIPTION OF WORK: Bathroom addition to the top floor. Pulling one new 20 amp 120v circuit for bathroom. <br /> Adding one recessed can light, bath fan, gfci receptacle. <br /> Altering one 15amp circuit in the room adjacent to the bathroom to move the light fixture. <br /> CONTACT INFORMATION <br /> OWNER NAME:Liberty TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 4806 Seahurst Ave <br /> cny Everett STATE Wa ZIP 98203 <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: Res Inc to a (DC j(0 <br /> CONTRACTOR ADDRESS: STREET826 ne 123rd st ` <br /> CITY Seattle STATE Wa ZIP 9,..812 .) <br /> CONTRACTOR PHONE: 206.229.1398 CONTRACTOR EMAIL:jeffaschatzl@gmail.com gmail.com <br /> CONTRACTOR LIC.#(REQUIRED): EC RESINI*830NP CITY OF EVERETT BUSINESS LIC.#( GIUIRED):ff kgr <br /> "1- <br /> PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 206.229.1398 <br /> Jeff Schatz CONTACT EMAIL:jeffaschatz1@gmail.com <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 /> PERMIT# <br /> //7/ /? E �� t ( -- Col <br /> Owner/ uthorize. ge t Signature Da a (Revised 9/23/2016) <br />