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425-259-2794 �J:18 p.m. 05-02-2017 3/3
<br /> ELECTRICAL PERMlT APPLICATION
<br /> ClTY OF EVERETT PERMtT SERVtC�S
<br /> 32D0 CEDAR STREET, EVERET�,WA 98201
<br /> . (P)425-25/-8810 � FAX 425-257-8857 E(E)everetteps@evere#twa.gov[ www.everetiwa,gov/permits
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<br /> PROJECT AD�RESS: BOATHOUSE H-1 H DOCK 94TH AVE
<br /> BU1L0lNG AREA(lf residentlal,new cnnstructlon,remodel,or addltEon) SF
<br /> BUILDINO TYpE: ❑SFR-DETACHED ❑SFR-A7TACHED ❑DUPLEX ❑MULT[-FAMtLY-#OF UNITS: 0 COMMERCIAL
<br /> US�OF HUILDING; BOATHOUSE
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<br /> CONTRACT PRIGE OF WORK: $ 500.
<br /> NUMBER OF DEVICES if low volta e :
<br /> FIRE AV1RM? ❑Y�S �NO
<br /> ASSOCtATED BUILOIHG PERMiT# if a licable :
<br /> DESCRIPTION OF WpRK: Install new power card and 50A cord cap to the boathouse eiectrical meter
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<br /> OWNER NAME: JOhn DUffe�l TENANT NAME If Commarcial):
<br /> OWNER MAILING ADDRESS: sraEFr
<br /> �„Y STEAMBOAT SPRINGS 9TA7E CQ Z,P
<br /> OWNER PHONE: 970-846-2379 OWNER EMAIL: duffey@springs[ps.COt11
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<br /> cONTRACTOR NAME: Seahurst Electrfc
<br /> CONTiZACTOR ADDRESS: 5�� 2915 Chestnut St
<br /> cm Everett gTA� wA
<br /> Z,P 98201
<br /> CON'FRACTOR PHOPIE: 425-Z5$-�$82 �p�RqCTOR EMAlL: receptfon@seahurst.CO1T1
<br /> CC�NTRACTOR UC.#(REQUIREDj: SEAHUE1099QN c�nr oF Ev�RErr auswEss�rc.#(REQUIRED ; 18763
<br /> PREMARY CONTACT: p OWNER �CONTRACTOR ❑OTHER(Please Specily)
<br /> CONTACT NAME: KII11 S17ti#F1 CONTACT PHONE: 425-258-1$82
<br /> PM -JefE Herrmann cvNTAcr eM,�v�: reeeption@seahurst.00111
<br /> AGFZEEMFNT:/hereby certify that!have�ad and examinad fhis appilcation and know the sama to be true and carrect All provlsions aflaws and onflnences govaming fhls lype
<br /> of w�ric wi!!be completed whetherspacired he�ein ornof. The granting ofa parmif does nof presuma to give enthorlty to vialate orcance/!he provisions o(any otherstale ar
<br /> loca!Iaw regufaffng canslrtiction or the pe�fartnance af carutractiorr. Thaf!am autNodzed 6y the awrrer of th/s prnperiy to perform tha xvrk for whiah epplication/s trrada and 1
<br /> camy/y wrth the 5late Cantractars Lew 7B.27 RC W and 296.2Q0 WRC.
<br /> Clty nf Everatt�lflcial Use Only
<br /> . PERMIT#
<br /> 5-� -�7 E
<br /> � �o�—o c�
<br /> er/Aut o ze Agent Stgnature Oate (Revlsed 8/23/2096)
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