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425-259-2794 x:57 a.m. 06-15-2017 2/2
<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 1 (E)everetteps@everettwa.gov I www.everettwa.gov/permits
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<br /> PROJECT ADDRESS: 3000 Rockefeller
<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: ®COMMERCIAL
<br /> USE OF BUILDING: Snohomish County Phase 5 DES
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<br /> CONTRACT PRICE OF WORK:$ 10400.00
<br /> NUMBER OF DEVICES(if low voltage): na
<br /> FIRE ALARM? 0 YES MI NO
<br /> ASSOCIATED BUILDING PERMIT#(if applicable):
<br /> DESCRIPTION OF WORK: Retro-fit 4ft fluorescent fixtures on third floor east, using lamp on driver solution.
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<br /> OWNER NAME: Snohomish County TENANT NAME(If Commercial):
<br /> OWNER MAILING ADDRESS: STREET
<br /> CITY STATE
<br /> ZIP
<br /> OWNER PHONE: OWNER EMAIL:
<br /> CONTRACTOR NAME: Seahurst Electric
<br /> CONTRACTOR ADDRESS: STREET 2915 Chestnut St
<br /> cry Everett STATE WA zlp 98201
<br /> CONTRACTOR PHONE: 425-258-1882 CONTRACTOR EMAIL: reception@seahurst.com
<br /> CONTRACTOR UC.#IREQULRED): SEAHUE1099QN CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 18763
<br /> PRIMARY CONTACT: 0 OWNER aa CONTRACTOR 0 OTHER(Please Specify)
<br /> CONTACT NAME: Kim Smith CONTACT PHONE: 425-258-1882
<br /> Terry Hicks CONTACT EMAIL: reception@seahurst.com
<br /> AGREEMENT:I hereby certify that/have mad and examined this application and know the same to be true and correct. All provisions of taws and ordinances governing this type
<br /> of work will be completed whether specified herein ornat The granting of a permit does not presume to give authority to violate or cancel the provisions of any other stale 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 I
<br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAC.
<br /> Cily of Everett Okla!Use Only
<br /> ( (7
<br /> ~ PERMIT#
<br /> Own uthorize <nt Signature Date (Revised 9/23/2016)
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