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425-259-2794 �:02 p.m. 05-02-2017 2/3
<br /> ELECTRICAL PERM�T APPLICATION
<br /> CITY OF EVERETT PERMIT SERVICES
<br /> 3200 CEDAR STR�ET, EVERETT,WA 98201
<br /> (P)425-257-8810 J FAX 425-257-8857 � (E)everet�eps@everettwa.gov� www.everettwa.gov/permits
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<br /> PROJECT ADDRESS: BOATH�USE H-34 H DOCK 14TH AVE
<br /> BUILDtNG AREA(if restde�tlel,new aonstrucllon,remodel,or addition) SF
<br /> BUILDING TYPE: ❑5FR-DETACHED ❑SFR-ATTACHED ❑DUPLEX ❑MULTI-FAMILY-#O�UNITS: �COMMERCEAL
<br /> USE OF BU[LD[NG: BOATHOUSE
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<br /> CONTRACT PR[CE OF WORK:$ 500.
<br /> NUMBER OF DEVICES if low volta e :
<br /> FIRE ALARM? ❑YE3 �IVO
<br /> ASSOCIATED SUILDING PERMIT# if a Iicable :
<br /> DESCRIPTtON OF WORK: Install new power cord and 50A card cap to the boathouse eleatrical meter
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<br /> OWNER NAME: St@V@ SCal20 'fENANT NAME(lf Cammercial:
<br /> OWNER MAELING ADDRESS: smeer 9057 NE 39TH PL
<br /> cnY YARROW BAY STA7E WA z,P 98004
<br /> oWNER PHOI�E: �06-930-6449 OWNER EMAR: sscatzo@foss.com
<br /> .... . ...........
<br /> coNraACroR�nME: SeahUrst Electric
<br /> CON7RACTOR AaDRESS: 5'SREET 2915 Chestnut St
<br /> �m. Everett BTATE WA � 98201
<br /> CONTRACTOR PHONE: 425'238"�882 CONTRACTOR EMAIL: reception@seahurst.COt11
<br /> CONTRACTOR L,[C.#(REQUfRED): SEAHUE10994N c��r op EVERErr susttv�ss uc,#�REQIlIRED): '�S7G3
<br /> ... ..... .. ... . .
<br /> PRIMARY CONTACT: ❑OWNER �CONTRACTOR ❑OTHER(Please Specify)
<br /> CONTACT NAME: KIn'1 SIi'llth COPiTACT PHONE: 4�5-258-1882
<br /> PM -.Jeff Herrmann coNrACT��tai�: reception@seaharst.com
<br /> AGREEMENT.•!hereby certify that I hsve fsad end examined this applicafion and kaaw the same fo 6e true end consct. Ap provisians af laws and arlinances goveming thls type
<br /> of wiork will be aomplalad whether spec�ed hereirr or noG Tha granting of a peimi7 Joes not presume�a grve authodfy to vinlate or canca/the p�nvisfans o/sny afher stafe or
<br /> lacal/aw regulat/ng consfn�ciion or the performance of construciian. Thal/em authodzed by the awner of this properly to perform!he work for whfah app/rcatTan is made and/
<br /> comply with fhe Steta Contracfars Law 18.27 RCYY and 296.200 WAC.
<br /> �' Clry of Evere#O�clal Use Only
<br /> • � % /�"] PERMlT#
<br /> �r� rr � E �l b5 -� �C`7
<br /> �wn r/ ut#�oHzed `ge� Slgnature Date
<br /> (Revlsad 9/23/2016)
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