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425-259-2794 27 a.m. 05-24-2018 2/2
<br /> � ELECTRICAL PERMIT APPLICATION
<br /> +41 ' �- 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.gov/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 ❑DUPLEX ❑MULTI-FAMILY-#OF UNITS: Ill COMMERCIAL
<br /> USE OF BUILDING: commercial retail
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<br /> CONTRACT PRICE OF WORK:$ 26000.00
<br /> NUMBER OF DEVICES (if low voltage); na
<br /> FIRE ALARM? ❑YES NI NO
<br /> ASSOCIATED BUILDING PERMIT#(if applicable): na
<br /> DESCRIPTION OF WORK: Energy conservation lighting retrofit.
<br /> 1111151•10111.1311,5•10-00041901:0#41110#
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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 /> cnr, Everett STATE WA zip 98201
<br /> CONTRACTOR PHONE: 425-258-1882 CONTRACTOR EMAIL: reception@seahurst.com
<br /> CONTRACTOR LIC.#(REQUIRED): SEAHUEIO99QN CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 18763
<br /> PRIMARY CONTACT: 0 OWNER Dia 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. Thal 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.
<br /> City of Everett Official Use Only
<br /> t
<br /> PERMIT#
<br /> A1P li 6 zci f g E bOS -• $
<br /> Ow er uthorized A : nature Date
<br /> (Revised 9/23/2016)
<br />
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