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425-259-2794 � �30:41 p.m. 04-12-2016 2/2 <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />320o CEDAR STREET, EVERETT, WA sa201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />409 Wood Place <br />PROJECT ADDRESS <br />Michael Mathis same <br />Owner Mail Addrsss Cfty Stala/Zlp Phone <br />Tenant <br />Seahurst Electric <br />ElecUical Contractor <br />SEAHUE'I 099QN <br />State License Number (required) <br />Mail Address <br />2915 Chestnut St <br />Maii Address <br />City <br />Everett <br />Clty <br />State2ip <br />WA/98201 <br />State2lp <br />Phone <br />425-258-1882 <br />Phone <br />18763 <br />City of Everett Business License Numher (required) <br />Residential 98fl- <br />Proposed Use of Building Contract Price of Work <br />Ross P�ather 425-7546077 <br />rprather@seahurst.com <br />Square Footage (If residential new construction, remodel or additian) Contact Person/Contact Num6er/Email <br />Number of devices (lf low voltage) <br />oesonpc�on of wortc co ae oone: Add GFI and arc fault protected cir�cuit for disposal <br />C(TY OF EVERETT LQCAL SALES TAX CODE IS 3105 <br />1 hereby ce�fify fhat I have r�sad and examined this applicafion and know ihe same to be trua and <br />correcf. All provisions oflaws and ordinances goveming this type of work will be complefed <br />whether specified herein or not. The granting of a permit does not presume fo give auihority to <br />violafe or cancel the provisions of any other state or /ocal /aw regulating consiru�iion or 1he <br />performance of construction. That 1 am authorized by fhe owner of this property to perform the <br />work for which application is made and I comply with the State Contracfors Law 18.27 RCW and <br />Z96.200 W C. ^ <br />� �/-�Z l� <br />/�� A <br />REVlSED OBR162014 <br />FEE <br />����, �� <br />PERMIT# <br />E��,��-� <br />