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425-259-2794 x:04 a.m. 05-17-2017 3/3
<br /> ELECTRICAL PERMIT APPLICATION
<br /> CITY OF EVERETT PERMIT SERVICES
<br /> 3200 CEDAR STREET, EVERETT,WA 98201
<br /> (P)425-257-8810 I FAX 425-257-8857 I (E) everetteps@everettwa.gov www.everettwa.govfpermits
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<br /> PROJECT ADDRESS: 5327 GLENWOOD AVE#B
<br /> BUILDING AREA(if residential,new construction,remodel,or addition) SF
<br /> BUILDING TYPE: in SFR-DETACHED 0 SFR-ATTACHED XI DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL
<br /> USE OF BUILDING: RESIDENTIAL
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<br /> CONTRACT PRICE OF WORK: ; 500.00
<br /> NUMBER OF DEVICES(if low oltage):
<br /> FIRE ALARM? ❑YES IN NO
<br /> ASSOCIATED BUILDING PER • :.plicable):
<br /> DESCRIPTION OF WORK: ADD (1) 120V CIRCUIT
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<br /> OWNER NAME: MARILYN PERALA TENANT NAME of Commercial):
<br /> OWNER MAILING ADDRESS: sTREET 5327 GLENWOOD AVE#A
<br /> CITY EVERETT STATE WA ZIP 98203
<br /> OWNER PHONE: 206-249-4667 OWNER EMAIL:
<br /> .
<br /> CONTRACTOR NAME: Seahurst Electric
<br /> CONTRACTOR ADDRESS: STREET 2915 Chestnut St
<br /> C,,, Everett STATE WA ZIP 98201
<br /> CONTRACTOR PHONE: 125-258-1882 CONTRACTOR EMAIL: reception@seahurst.com
<br /> CONTRACTOR LIC.#(REQUIRED): SEAHUE1099QN CITY OF EVERETT BUSINESS LIC.#(REQUi ED): 18763
<br /> PRIMARY CONTACT: ❑OWNER I$I CONTRACTOR 0 OTHER(Please Specify)
<br /> CONTACT NAME; Kim Smith CONTACT PHONE: 425-258-1882
<br /> PM -ROSS PRATHER CONTACT EMAIL: reception@seahurst.com
<br /> AGREEMENT:I hereby certify that/have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type
<br /> of work will be completed whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or
<br /> local law regulating construction or the performance of construction. That I am authorized by the owner of this property to perform the work for which application is made and I
<br /> comply with the Slate Contractors Law 18.27 RCW and 296.200 WAG.
<br /> City of Everett Official Use Only
<br /> PERMIT#
<br /> / 6-17-17 EIC -- ��
<br /> ner/Author ed Agent Signature Date (Revised 9/23/2016)
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