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4E77- ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P) 425-257-8810 I FAX 425-257-8857 I (E) everetteps@everettwa.gov I www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: 10524 19th Ave SE <br /> BUILDING AREA(if residential, new construction, remodel, or addition)5000 SF <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: Banking <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK,`. t 1500 J NUMBER OF DEVICES (if low vo"(tage): 10 cables <br /> FIRE ALARM? 0 YES �� m NO J' <br /> ASSOCIATED BUILDING PERMIT (if applica Ye): <br /> DESCRIPTION OF WORK: pull cables for furniture network stations <br /> CONTACT INFORMATION <br /> OWNER NAME: Opus Bank TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 19900 Macarthur Blvd, 12th Floor <br /> Dry Irvine STATE CA ZIP 92612 <br /> OWNER PHONE: OWNER EMAIL: Jack Albright <JAlbright@opusbank.com> <br /> CONTRACTOR NAME: SeaCom Cabling <br /> CONTRACTOR ADDRESS: STREET 3014 Hoyt Ave \ <br /> Everett STATE WA ZIP 9, 201 <br /> CONTRACTOR PHONE: 4252935094 CONTRACTOR EMAIL: tjohnson@callseacom.com <br /> CONTRACTOR LIC.#(REQUIRED): SEACOCI944DO CITY OF EVERETT BUSINESS LIC.#(REQUIRE ):DS3C' <br /> PRIMARY CONTACT: 0 OWNER I;[7 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 4252935094 <br /> Troy Johnson CONTACT EMAIL:tjohnson@callseacom.com <br /> AGREEMENT:I hereby certify that 1 have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type <br /> 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 <br /> local law regulating construction or the performance of construction. That I am authorized by the owner of this property to perform the work for which application is made and I <br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> PERMIT# <br /> E Req - <br /> Owner/ <br /> ori gent Signature Date (Revised 9/23/2016) <br />