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425-259-2794 0 <br /> it2:50 p.m. 11-14-2016 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.evereftwa.org <br /> 1932 Broadway <br /> PROJECT ADDRESS <br /> Althea Schlumpf 1932 Broadway Everett WA/98201 425-303-0108 <br /> Owner Mall Address City State2ip Phone <br /> Tenant Mall Address City State2ip Phone <br /> Seahurst Electric 2915 Chestnut St Everett WA/98201 425-258-1882 <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> SEAHUE1099QN 18763 <br /> State License Number(required) City of Everett Business License Number(required) <br /> 1500.00 <br /> Proposed Use of Building Contract Price of Work <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 (6) 120v quad receptacles in new counter Install (1) 120v <br /> receptacle in wall behind counter Install (1) 120W quad receptacle <br /> behind counter / Reuse existing circuits to feed new receptacles. <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 Q� O <br /> 1 hereby certify that I have read and examined this application and know the same to be true and o <br /> correct. All provisions oflaws and ordinances governing this type of work will be completed <br /> whether specified herein or not. The granting of a 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 r <br /> performance of construction. That I am authorized by the owner of this property to perform the t 1` <br /> work for which application is made and 1 comply with the State Contractors Law 16.27 RCW and <br /> 296.200 WAC. <br /> Sj6ratum Date <br /> REVISED 08/0612014 <br />