|
425-259-2794 :40 a.m. 05-22-2017 2/2
<br /> �,- • ELECTRICAL PERMIT APPLICATION
<br /> �*�✓a J CITY OF EVERETT PERMIT SERVICES
<br /> 3200 CEDAR STREET, EVERETT,WA 98201
<br /> (P)425-257-8810 J FAX 425-257-8857 ] (E)everetteps@everettwa.gov( www.everettwa.gov/permits
<br /> 11:12........
<br /> ..._.��.._..._ 4 ._._... _ ::r..:......._._......._......_,.vt_ fit.,...,:..�_�O.�..Eri ► T�;�NF�RN�7 $. I-� �:::w ��-- -
<br /> ::_><__.:,-__:,,_i_ .iii,_.___._.....-•----..._ ,,...-
<br /> PROJECT ADDRESS: 729 100TH ST
<br /> BUILDING AREA(if residential,now construction,remodel,or addition) SF
<br /> BUILDING TYPE: ❑SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: III COMMERCIAL
<br /> USE OF BUILDING: DEPARTMENT OF LABOR&INDUSTRIES
<br /> ..tl..._.` ......t..........,-St... :::e.,si:::U.:....:....................__............._..._«,..,.,�re....,i�•-:t•�"=.i`..
<br /> ......-.t.......I....:..........s....-•......„_:.... s........._.-.,..t......-....... S..,tss .. .. .... ... :t':S�:L4si:•t?,.�......-......:..,...i_.....::...«;._.......y... _._i..s..
<br /> ........c.._......................s t - ...1..-:............. :: ., ,: c: .� .::�.:. :::1'it._.:.n•:.r.:tc:sy.:�i.^rC:.:::..:..
<br /> .....................c. .........-_....,i..«.a.«.i...s.i - _ .. i 3 .. :xs:a:: u:n.::,S:mir.>:
<br /> ,.. ...i... .....................__........._�_......,.,<.�LE.CY �� L. P�.[ T . fib. . . ...._..::,;I�...t... _ _
<br /> _t_..__..........,t..:._..< i�1�!. .. ��il. .II�NrIl�1 A:. :: Oi . . . . ,,...._..:__..... ............_;,..�:�
<br /> s...t........ i..... ....r_s. __.._......a...._.„_..................._._..._ .-...«. .�,�.,,���.'::•.�:';'t::::-'t-� :3:4•�::xss:•3�...._.....,t, -
<br /> iiiiii
<br /> _ .:.....:.....•-.s....)..t sa��:s.A........ y.G.. .s.__..........n,se..-rtx,,,..”S=:s�3....r::i:S•e•�_,�..:...x.r ...s:•::::...... rs
<br /> CONTRACT PRICE OF WORK:$ 920.
<br /> NUMBER OF DEVICES(if low voltage):
<br /> FIRE ALARM? 0 YES 0 NO
<br /> ASSOCIATED BUILDING PERMIT#(if applicable):
<br /> DESCRIPTION OF WORK: ADD (2) RECEPTACLES UTILIZING EXISTING CIRCUITS AND RELOCATE (1)
<br /> QNT,EI M . tfNtAT :>t:.:»�::n,;:: .::�..��: >�;
<br /> J -
<br /> OWNER NAME: SCOTT JOHNSON TENANT NAME(If Commercial): DEPT OF L&I
<br /> OWNER MAILING ADDRESS: SrREEr PO BOX 5253
<br /> CITY EVERETT STATE WA ZIP 98203
<br /> OWNER PHONE: 4254084670 OWNER EMAIL:
<br /> CONTRACTOR NAME: Seahurst Electric
<br /> CONTRACTOR ADDRESS: STREET 2915 Chestnut St
<br /> onv Everett STATE WA ZIP 98201
<br /> CONTRACTOR PHONE: 425-258-1882 CONTRACTOR EMAIL: reception@seahurst.com
<br /> CONTRACTOR UC.#(REQUIRED): SEAHUE1099QN CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 18763
<br /> PRIMARY CONTACT: 0 OWNER ®CONTRACTOR 0 OTHER(Please Specify)
<br /> CONTACT NAME: Kim Smith CONTACT PHONE: 425-258-1882
<br /> PM -JUSTIN KERR CONTACT EMAIL: reception@seahurst.com
<br /> AGREEMENT:I hereby certify that I have read and eramined 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 stale or
<br /> local law regulating construction or the performance of construction. That lam 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 /> 6”) 1� E - 139
<br /> Ow er/Authorized A ent Signature Date (Revised 9/23/2016)
<br />
|