1205 CRAFTSMAN WAY SLIP 15 DOCK H 2021-12-06

ELECTRICAL PERMtT APPLICATION CITY O�EVERETT PERMIT SERViCES 3200 CEDAR STREET,EVERETT,WA 98241 (P)425-257-8810 � FAX 425-257-8857 �(E)everetteps@everettwa.gov� www.everettwa.gov/permits PROJECT S1TE INFORMATION PROJECTADDRESS: 12OrJ CrSftSC11aC1 Wa , DoCk H, Sli #H15 BUILDING AREA(if residen6al,new construction,remodel,or addition) N/A SF BUILDING TYPE: ❑SFR-DETACHED ❑SFR-ATTACHED ❑DUPLEX ❑MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL USE OF BUILDING: BOat SII ELEGTRICAC APPLfGAT10N tNFORMATION CONTRACT PRICE OF WORK:$ 700.00 NUMBER OF DEVICES(if low volta e : 1 FIRE ALARM? ❑YES 0 NO ASSOCIATED BUILDING PERMIT# if a licable: DESCRIPTION OF WORK: lnstallation o#a shore powrer ouilet to the existing power pedestai,required by the Port of Everett CONTACT`iNFORMATION OWNER NAME�arrY Befdan TENANT NAME(tf CommerCial : OWNER MAILING ADDRESS: snzeer 17602 NE 134th Place Redmond �,N STAIEWA �,P 98052 OWNER PHONE: 206-60'4'-5767 OWNER EMAIL: corrrRacroR ruanne:W E Electric CONTRACTOR ADDRESS: srneEr PO BOX Z4Z7 �,TM Redmond STA,�WA Z,P 98073 CONTRACTOR PHONE:4ZrJ-�JO$-G3HZ CONTRACTOR EMAIL: rUth.lNyltlC W@eIG'CtCIC.COfII corrrRacroR uc.��ReQuiRe�>: WEELEEE9104U CITY OF EVERETT BUSINESS LIC.#(REQUIRED):57075 PRIMARY CONTACT: ❑OWNER 0 COI�lTRRCTOR ❑OTFlER(Please Specify) CONTACT NAME: CON7ACT PHONE: 42�j-�j�$-6$$2 RUth W�/a'� CONTACTEMAIL:rUtI1.W�l1tt�W@@I@Ctl'tG.00171 AGREEMENT:I hereby certify fhat t have read and examined this application and lmow the same to be true and correct All provisions of laws and ordinances governing this type of work wi//b�e comp/eted wh�+herspecilied herei�ornot The gra�8ng ofa p�emfit cbes nat presume to give authority to violate or cancel the provisions of anyolher state or local law regula6ny construction or the performance of consWction. That/am authnr'�zed by!he owner of this property to perinrm the work for which applica6on is made and I comply with the State Contractors Law 18.27 RCW a�296201)WAC. City of Everett Offiaal Use Only PERMIT# Ef�b�� «v Owne Autho zed Ag Signature Date (Revised 9/23/2016)