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425-259-2794 :39 p.m. 04-18-2017 3/3
<br /> ELECTRICA� PERMIT APPLNCATION
<br /> CITY OF EVERETT PERMIT SERVICES
<br /> 3200 CEDAR STREET, EVERETT,WA 98201
<br /> (P)425-257-8890 � FAX 425-257-8857 � (E)everetteps@everettwa.gov( www.everetiwa.gov/pertnits
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<br /> PRo.��cT ApoREss: Central Marina Dock H -9135 Craftsman Way/Grimm Baathouse H-5
<br /> BUILDING AREA(!f resldentEat,new cr�nstruction,remadel,or additlon) SF
<br /> BUILOING l'YPE: �3FR-DETACHED L7 SFR-ATf'ACHED ❑DUPLEX ❑MULTi-FAMILY-#1 OF UNlTS: �COMMERCIAL
<br /> USE oF BUILDMG: Boathouse H-5
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<br /> CONTRACT PRIGE OF WORK: $ 700.00
<br /> NUMBER O�DEVICES if low volta e ;
<br /> FIRE ALARM? 17 YES �NO
<br /> ASSOCIATED 6UILDtNG PPRM[T# if a IEcable:
<br /> DESCRtPTION OF WORK: Install (1j 30A Pawer Cord on Boa#house H-5
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<br /> OWNEft NAME: Tom Grimm TENANI'fJAME 1f Comrnercial:
<br /> OWNEft MAIUNG ADbRESS: srxeer
<br /> C� STATE � ZIP �
<br /> OWNER PHONE: �06-654-2244 OWNER EMAII.: 9���'►tim�ryanlaw.CORI
<br /> ......... .
<br /> CONTiZACTOR NAME: Seahurst Electr€c
<br /> CONT(tACTOR ADDRHSS: �ee: 2515 Chestnut St
<br /> cm Everett gTA7E W�► Z� 98201
<br /> CONTRACTaR PHONE: �25�258-�882 coNrr�ACYOR eM��: reception�seahurst.COt17
<br /> CONTItACTOR UC.#(REQUlREO): �EAHUE10994N crnr aF�veRErr eusiN�ss uc.#REQUIRED): 1$7�$
<br /> ... .. . ..... .. .. . _
<br /> PRIMARY CONTACT: �]OWNER l�CONTRACT�R ❑OTHER(Pleasa Specify)
<br /> CONTACT fVAME: Kllri S1171�f1 CQNTACT PWONE: 425-258-1882
<br /> COtdTACT EMAIL: feCej)t(011 QeS@�hUl'St.CORl
<br /> AGREEMEN7:•l hareby certify fhaf I heve read and ezemined this applicetion and know the sama to be true and oorteet. AIJ provigions of laws and ardinances govemtng thls typa
<br /> of work wiU be calnplaled whethar spac�ed ha�eln orrtot. 7ha granting of a permrf does not presume!o glve aulho�fty lo vlolate or cancel the provls(ans of any athar slate or
<br /> local law ragulating sonshvclian or the performance af constructian. That I am authodzed by the awner of this praperty to perform tha work for whlch application Is mada and I
<br /> compiy with the Stata Cantractors Law 98.27 RCW and 296.200 WAC.
<br /> C�Iy of Evereft Offialal Use pnty
<br /> . \ PERMIT#
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<br /> � -r�-�� E �� H � zz
<br /> n Authorl Agent 5fgnature Date (ReV/sed 9/23/201fi)
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