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425-259-2794 =1 27 a,m. 05-24-2018 2/2
<br /> ELECTRICAL PERMIT APPLICATION
<br /> y- CITY OF EVERETT PERMIT SERVICES
<br /> Noiliti73200 CEDAR STREET, EVERETT,WA 98201
<br /> (P)425-257-8810 1 FAX 425-257-8857 1 (E)everetteps@everettwa.gov J www.everettwa.gav/permits
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<br /> PROJECT ADDRESS: 1605 SE Everett Mall Way
<br /> BUILDING AREA(If residential,new construction,remodel,or addition) SF
<br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: lil COMMERCIAL
<br /> USE OF BUILDING: commercial retail
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<br /> CONTRACT PRICE OF WORK:$ 26000.00
<br /> NUMBER OF DEVICES (if IOW voltage): na
<br /> FIRE ALARM? 0 YES III NO
<br /> ASSOCIATED BUILDING PERMIT#(if applicable): na
<br /> DESCRIPTION OF WORK: Energy conservation lighting retrofit.
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<br /> OWNER NAME: WALMART TENANT NAME(If Commercial):
<br /> OWNER MAILING ADDRESS: STREET
<br /> CITY STATE ZIP
<br /> OWNER PHONE: OWNER EMAIL:
<br /> CONTRACTOR NAME: Seahurst Electric
<br /> CONTRACTOR ADDRESS: STREET 2915 Chestnut St
<br /> ci,., Everett STATE WA ZIP 98201
<br /> CONTRACTOR PHONE: 425-258-1882 CONTRACTOR EMAIL: receptlon@seahurst.com
<br /> CONTRACTOR UC.#(REQUIRED): SEAHUEI099QN CITY OF EVERETT BUSINESS LIC.#REQUIRED): 18763
<br /> PRIMARY CONTACT: 0 OWNER all CONTRACTOR 0 OTHER(Please Specify)
<br /> CONTACT NAME: Kim Smith CONTACT PHONE: 425-258-1882
<br /> PM- Rachael Riekin 425-508-7172 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 tam authorized by the owner of this property to perform the work for which application is made and t
<br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAC.
<br /> City of Everett Official Use Only
<br /> S PERMIT#
<br /> 5 /ZCI)/6
<br /> Ow or uthorized A! nature Date (Revised 8/23f2016)
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