10204 MONTANA RD 2017-06-22 - Laserfiche WebLink

425-259-2794 3:08 a.m. 05-23-2017 212 ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES OL 3200 CEDAR STREET, EVERETT,WA 98201 (P) 425-257-8810 FAX 425-257-8857 1 (E)everetteps@everettwa.gov www.everettwa.gov/permits PROJECT SITE INFQRMATIQN,. :„ PROJECT ADDRESS: 10204 MONTANA RD BUILDING AREA(if residential, new construction,remodel,or addition) SF BUILDING TYPE: ❑SFR-DETACHED 0 SFR-ATTACHED ❑DUPLEX ❑ MULTI-FAMILY-#OF UNITS- ❑ COMMERCIAL USE OF BUILDING: RESIDENTIAL EL C IGAL APPLICATION INPORMATtON CONTRACT PRICE OF WOR . $ 500. 11/ NUMBER OF DEVICES if low voltage),_---,-,. olts e;-- FIRE ALARM? ❑YES ®NO ASSOCIATED BUILDING PERMIT# if applicable): DESCRIPTION OF WORK: ADD 1 20AMP 120VOLT CIRCUIT TO RE-POWER EXISTING KITCHEN RECEPTACLE CONTACT INPORNIATIQ.N .... OWNER NAME: CHRYSTAL TCHAN TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET 2107-D WEST COMMONWEALTH AVE#405 CITY ALHAMBRA STATE CA zip 91801 OWNER PHONE: 629-231-1300 OWNER EMAIL: CONTRACTOR NAME: SeahurSt Electric CONTRACTOR ADDRESS: 6TREET 2915 Chestnut St cRv Everett STATE WA Zip 98201 CONTRACTOR PHONE: 425-258-1882 CONTRACTOR EMAIL: reception@Seahurst.com CONTRACTOR UC.#(REQUIRED): SEAHUE1099QN ICITY OF EVERETT BUSINESS LIC.#(REQUI yD): 18763 PRIMARY CONTACT: ❑OWNER X CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: Kim Smith CONTACT PHONE: 425-258-1882 PM -ROSS PRATHER CONTACT EMAIL: reception@seahurst.com AGREEMENT:f 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 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 local law regulating construction or the performance of construction. That I am authorized by the owner of this property to perforin the work for which application is made and/ comply with the State Contractors Law 18.27 RCW and 296.200 WAC, City of Everett Oficial Use Only PERMIT# E 1S - PSZ O na uthorizad A nt Signature Date (Revised 9123/2016)