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425-259-2794 ^:i:^:9:52 a.m. 10—OS-2017 2/2 <br /> ELECTRICAL PERMIT APPLtCATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8B10 � FAX 425-257-8857 � (E)everetteps@everettwa.gov � www,everettwa.gov/permits <br /> _..::. . . .�__: _...,; . . : :_. . �.., :: .... ...': ..p��J�±CT Sl`rt`� y�F�3RMA�t�O�....; ` -: <br /> _.___ __. __ <br /> PRo�Ecr A�nREss: 7601 EVERGREEN WAY <br /> BUILDING AREA(if residentlal,new construction,remodel,or additlon) SF <br /> BUILDING TYPE: ❑5FR-DETACHED ❑ SFR-ATTACHED ❑DUPLEX � MULTI-FAMILY-#�OF UNITS: �COMMERCIAL <br /> USE OF BUILDING: RETAIL <br /> ,a <br /> : __.. '.:._ EkECTI� _;��. }�PP'LICAT'�O�+M tN�tJRN11r"�'��N . ' <br /> _ ____................... <br /> CONTRACT PRICE OF WORK: 800.00 ` <br /> NUMBER OF DEVICES if low v Ita e : NA;' <br /> FIRE ALARM? ❑YES � � �O <br /> ASSOCIATED BUILDING PERMIT# if a licable :NA <br /> DESCRIPTiON OF WORK: INSTALL (1) 20A/120V BRANCH CIRCUIT & RECEPTACLE FOR PRINTER <br /> - _ � <br /> ,.. :: G�71�1�''�#�T 1NFORIVII}T��N <br /> ' � ;: ;: r <br /> ...... . ., . :,. . ' <br /> OWNER NAME: TENANT NAME(If Cammercia : .lO-ANN STORES#789 <br /> OWNER MAILING AD�RESS: srnEer <br /> arv srn ziP <br /> OWNER PHONE: �WNER EMAIL: <br /> CONTRACTOR NAME: SE:ahUfSt EI@CtfiC ' — <br /> CONTRACTOR ADDRE5S: �E�r 2915 Chestnut St <br /> �,TM Everett STATE WA <br /> Z,P 98201 <br /> CONTRACTOR PHONE: 425-255-1882 coNrtzacroR Ennai�: reception@seahurst.com <br /> coNTttacTOR�ic.t�REQuiReo>: SEAHUE1099QN CITY OF EVEREIT BUSINESS L1C.#(REDUIRED): 18763 <br /> PRIMARY CONTAGT: ❑OWNER �CONTRACTOR ❑OTHER(Please SpeC(fy) <br /> CONTACTNAME: Klill SR11tI1 CONTACTPHONE; 42�J-258-�882 <br /> PM-JON N�VY 425-508-4320 cotJracT�Ma��: reception@seahurst.com <br /> AGREEMENT_1 hereby certrfy that I heve read end oramined this app/lcation and know the same to bc+true and correct. All provrsions of lews and arr/rnances goveming ihis typs <br /> o(work wi/1 be complefed whelher speci�ed herein or not. The grantrng of a permit does not presume fo yive authonly to violate or cancoi tha provisrons of sny olher stafe or <br /> local!aw regulafing consta�ction or Ihe perfortnance af constn�ction. That!am aulhorrzed bylhe owne�of this property to perform fhe work for which applicafion is made and f <br /> cnmply wiih the State Contracfors Law 78.27 RCW and 296.20D WAC. <br /> Crty of Everatl O�cial Use Only <br /> ��" � ;`�,�-.� PERMIT# <br /> a s!. >� ,� � r- 3�,„,,, <br /> ' ��` �""���,��� �'�' >>�� �� E �`� � d -- a�( C� <br /> .fr�'.�tf l��'. ,� �/ t�",.J��''� t�' f '`� .f�+ <br /> 4 � <br /> �OlGnar/Authar�zed Agent Slgnature Oate (Revised 923/2U16) <br />