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425-259-2794 17�3:36 p.m. 10-05-2017 2/2
<br /> II I
<br /> ELECTRICAL PERMIT APPLICATION
<br /> CI7Y OF EVERETT PERMIT SERVICES
<br /> 3200 CEDAR STREET, EVERETT,WA 98201
<br /> (P)425-257-8810 [ FAX 425-257-8857 � (E)everatteps@everetiwa.gav J www.everettwa.gov/permits
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<br /> PROJEC7 ADDRESS: 2'I21 ASIN� RD
<br /> BUILDING AREA(lf residentEal,new constructlon,remodel,ar addition) SF
<br /> BWL�ING TYPE: ❑SFR-DETACHED ❑ S�R-ATTACHED ❑DUPLEX ❑MULTI-FAMILY-#OF UNITS: �COMMERCIAL
<br /> USE OF HUlLDING: SOFTWARE COMPANY
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<br /> CONTRACT PRICE OF WORK:$ 12000.�0
<br /> NUMBER OF DEV[CES if low volta e : NA
<br /> FtRE ALARM? ❑YES �NO
<br /> ASSOCIATED BUILDfNG RERMfT# if a [icable : NA
<br /> DESCRIPTiON OF WORK: INSTALL(1) 1 OOAMP SUB PANEL
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<br /> QWNER NAME: Of€ice Contact: Craig Hughes TENANT NAME If Cammarciaf): WS�PC
<br /> OWNER MAILING ADDRESS: s�eer �
<br /> �� STATE �ZIP
<br /> OiMNEit PHONE: 425-309-6600 E3WNER EMAIL: chughes@wsipc.arg
<br /> coNTRACTOR NAME: Seahurst Etectric
<br /> CONTAACTOR ADDRESS: sr�EEr 2915 Chestnut St
<br /> cm, Everett SSA,� WA z,P 98201
<br /> CONTRACTOR PHONE: 425-258-�$$2 CONTRACTpR EMAIL: receptlon@seahurst.COTt1
<br /> CONTRACTOR LIC.#(REpU1RED): SEAHUE1099QN c��nr oF Ev�RErr Bus�Ness Lic.#(REQUIRED}; 18763
<br /> PRIMARY CONTACT: C1 OWNER 18f CONTRACTOR �OTHER(Rlease 5pecify)
<br /> CONTACT NAME: KI[Tl SI7'il�Fl CONTACT PH�NE; 425-258-1882
<br /> PM -JEFF HERRMANN 425-309-2554 coNTact EMa�: receptlon@seahurst.com
<br /> A�REEMENT.•f hereby cedriy that 1 have read and eramined thts app!lcatfon and knaw tha same to 6e true end correct. Afl provlslons of laws and orr/inancss gaveming ihis typa
<br /> of work wi1!6e complated whetharspecJfled herein ornot. The grantrng af a permft daes nnt presume lo gfve authodfy to violate nr cancel the praNsfans oi any ofher stafe or
<br /> Foca!law r�gulafing construction or ihe performance of conslrsrcffon. That I am authorized by the owner of this properfy fo perfarm Ihe wodc for whtch applicafion is made and►
<br /> campiy wifh fhe State Contraetors Law 18.27 RCW and 296.Y06 WAC.
<br /> Clty of Everatf O�cfa/Use Only
<br /> � PERMiT#
<br /> :���� �� -��� E -� D�k�
<br /> Ow erlAuthorized�A�efnt Slgnature Date (Revfsad 9/23/2096)
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