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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 i www.everettwa.gov/permits
<br /> PROJECT ADDRESS: 5729 Broadway
<br /> BUILDING AREA(if residential,new construction,remodel,or addition)residential SF
<br /> BUILDING TYPE: 21 SFR-DETACHED 0 SFR-ATTACHED 0 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 voltage):
<br /> FIRE ALARM? 0 YES ®_NO
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<br /> ASSOCIATED BUILDING PERMIT#(if applicable): M1808-069
<br /> DESCRIPTION OF WORK: 20amp Dedicated circuit for heat pump
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<br /> OWNER NAME:Breanna Nyeazi TENANT NAME(If Commercial):
<br /> OWNER MAILING ADDRESS: sTREET 5729 Broadway
<br /> circ Everett STATE WA ZIP 98203
<br /> OWNER PHONE: 4.25-219-2572 OWNER EMAIL:brenyeazi@hotmail.com
<br /> CONTRACTOR NAME: SeatOWn Electric Corp.
<br /> CONTRACTOR ADDRESS: STREET 3431 Broadway
<br /> cnY Everett STATE WA ZIP 98201
<br /> CONTRACTOR PHONE:206-905-3690 CONTRACTOR EMAIL: permits@seatownservices.Com
<br /> CONTRACTOR LIC.#(REQUIRED): SEATOEC86ORB CITY OF EVERETT BUSINESS LIC.#(REQUIRED):53916
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<br /> PRIMARY CONTACT: ❑OWNER la CONTRACTOR 0 OTHER(Please Specify)____
<br /> CONTACT NAME: CONTACT PHONE: 206_905-3690
<br /> Bekah Swanson CONTACT EMAIL:permits@seatownservices.com
<br /> AGREEMENT:1 hereby certify that I 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 lam authorized by the owner of this property to perform the work for which application is made and I
<br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAC.
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<br /> City of Everett Official Use Only
<br /> " ",e' i`: PERMIT#
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<br /> Ow r/Au, •n<< t Signature D to (Revised 9/23/2016)
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