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425-259-2794 ""i=:42 a,m. 06-12-2017 2/2 <br /> U <br /> 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 /> .---._..,__._..........................xa:J,a.x...-.a.......•---.-.-..._. ...,.........._.... . ...iP . .R..i�:�`.,SnE:,[. FQR k :, ...�...._., ...x:::��:.�::::::::,�::�::.•_::::�,:� <br /> it = ._.....:....... :�-::r:;,;::::,:�:,:::::;.,T <br /> PROJECT ADDRESS: 6133 Lake Champlain Rd <br /> BUILDING AREA(if residential,new construction,remodel,or addition) SF <br /> BUILDING TYPE: O SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: IA COMMERCIAL <br /> USE OF BUILDING: City of Everett Water Plant <br /> oaczCw . x.... - x ¢a •H -.... ..... ' _,:•:: T0 .r, E <br /> . . al. :j: <br /> : •a...:._-<:Li'ce <br /> .... <br /> HI_ <br /> IEI <br /> CONTRACT PRICE OF WORK:$05000.00 <br /> NUMBER OF DEVICES(if low vol :.•e): <br /> FIRE ALARM? 0 YES 0 NO <br /> ASSOCIATED BUILDING PERMIT# _•• •-.le): <br /> DESCRIPTION OF WORK: <br /> Work to be performed under : JOC co tract. Partial Plant Lighting Upgrade <br /> OWNER NAME: City of Everett TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET <br /> CIN STATE ZIP <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: Seahurst Electric <br /> CONTRACTOR ADDRESS: STREET 2915 Chestnut St <br /> ctTv Everett STATE WA zip 98211 <br /> CONTRACTOR PHONE: 425-258-1882 CONTRACTOR EMAIL: reception@seahurst.com • <br /> CONTRACTOR LIC.#(REQUIRED): SEAHUE1099QN CITY OF EVERETT BUSINESS UC.#(REQUIREr): 18763 <br /> PRIMARY CONTACT: ❑OWNER IN CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: Kim Smith CONTACT PHONE: 425-258-1882 <br /> PM:Teny Hicks 425-754-2987 CONTACT EMAIL: reception@seahurst.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 lam 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 ROW and 296.200 WAG. <br /> City of Everett Official Use Only <br /> PERMIT# <br /> �i �� (; /x-/17 E l -©% <br /> r/ uthor,Agent Signature Data (Revised 9/23/2018) <br />