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425-259-2794 12:0 p.m. 11-30-2016 2/2 <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> 4027 4Th ST SE <br /> PROJECT ADDRESS <br /> City of Everett 2930 Wetmore Ave Everett <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> Seahurst Electric 2915 Chestnut St Everett tNA/98201 425-258-1882 <br /> Electrical Contractor Mail Address City ! State/Zip Phone <br /> SEAHUE1099QN 6rV20 <br /> 63 <br /> State License Number(required) Everett Business License Number(required) <br /> . <br /> Proposed Use of Building Contract Price of Work <br /> -Jeff Herrmann 425-309-2554 <br /> jherrmann@seahurst.com <br /> Square Footage (If residential new construction,remodel or addition) Contact Person/Contact Number/Email <br /> Number of devices(If low voltage) <br /> Description of Work to Be Done: Install (3) 27"Monitors with wire mold and add (3) outlets from existing circuits <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 I r(l„1 1 C 0 <br /> 1 hereby certify that I have read and examined this application and know the same to be true and 1 � J <br /> correct. All provisions of laws and ordinances governing this type of work will be completed <br /> whether specified herein or not. The granting ofa,permit does not presume to give authority to PERMIT# <br /> violate or cancel the provisions of any other state or local law regulating construction or the <br /> performance of construction. That I am authorized by the owner of this property to perform the <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> Signature Date <br /> REVISED CBX612014 <br />