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��� "�SB:SBa.m. 06-13-2073 Z�Z <br /> 1 <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PfRMIT SERVICE^ <br /> 3200 CEDAR STREET, EVERETT, WA 982U1 / �13`13 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwai.org b <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM T04 PM C �3Ob`� �07 <br /> 10921 191h Ave SE <br /> PROJECT ADDRESS <br /> Chevren <br /> Owner Mail Address Ciry SlalelZip Phcne <br /> Tenanl Mnil Address Ciry State2ip Phone <br /> Seahurst Electric 2915 Cheslnut St Everett WA I 98201 425-256-'i R82 <br /> Elaclrical Conlraclor Mnil Address Ciry State2lp Phone <br /> SEAHU E1 D99QN 450.OD <br /> State Llcen,e Number Conlract Price of Work <br /> Commer:lal <br /> Proposed Use of 8uilding Conlact Person (Plan Review) <br /> Square Faolage(If resldentlal new constructlon,remodel or addlllon) <br /> Descnplian ot Work to Be�one: Add (1)20A 120V dedicated clrcuit <br /> i <br /> NOTG: N.";�ING IN NON-DWELLINGS IS REQUIRED TO �E <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> 56.00 <br /> CITY OF EVERETT LOCAL SALES TNC CODE IS 3105 <br /> 1 horeby certily fhat 1 have mad and examined thls applicallon and know fhe same!o be frue and <br /> coRecL All provlsions o!laws and ardinances gavaming fhis type al worfr will be completed . <br /> whelher s eci�od hereln or no1. Tha ranlin o/❑ emnt does no( rvsume(o ive authoril fo � T /�p <br /> viola(eorPoncelthe provisionsolenyother9fateorlocallawreguPatingcansfrucfionortheY � I �L��' (,' 0 <br /> pedormance o!consfmction. Thut 1 nm aulhnnzed by fhe owner o/this pmperty to pertorm fhe <br /> �iork�or which application is made and I comply with the Slate Contracrors Law 18.27 RCW and <br /> 296.200 WAC. <br /> `� n'L ���� � -/3/..3 <br /> SlgnaWrc Da�e <br />