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425-259-2794 05:03:28 p.m. 05-09-2017 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 I (E)everetteps@everettwa.gov I www.everettwa.gov/permits
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<br /> PROJECT ADDRESS: 6300 Merrill Creek Parkway Suite A 100
<br /> BUILDING AREA(If residential,new construction,remodel,or addition) SF
<br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED ID DUPLEX 0 MULTI-FAMILY-#OF UNITS: II COMMERCIAL
<br /> USE OF BUILDING:
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<br /> CONTRACT PRICE OF WORK:$ 1000.
<br /> NUMBER OF DEVICES(if low voltage):
<br /> FIRE ALARM? D YES Irl NO
<br /> ASSOCIATED BUILDING PERMIT#(if applicable):
<br /> DESCRIPTION OF WORK: Install additional circuit for existing office
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<br /> OWNER NAME: YA. erC LL(...1) mike: e -kov
<br /> OWNER MAILING ADDRESS: STREET S-CA
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<br /> OWNER PHONE: OWNER EMAIL:
<br /> CONTRACTOR NAME: Seahurst Electric
<br /> CONTRACTOR ADDRESS: „„Er 2915 Chestnut St
<br /> ore Everett STATE WA ZIP 98201
<br /> CONTRACTOR PHONE: 425-258-1882 CONTRACTOR EMAIL: reception@seahurst.com
<br /> CONTRACTOR LIC.#(REQUIRED;: SEAHUE1099QN CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 18763
<br /> PRIMARY CONTACT: D OWNER l>D CONTRACTOR CI OTHER(Please Specify)
<br /> CONTACT NAME; Kim Smith CONTACT PHONE: 425-258-1882
<br /> PM:Brian Pyle 425-760-1470 CONTACT EMAIL: reception@seahurst.com
<br /> AGREEMENT:I hereby certify that I have read and examined this application end 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 properly to perform the work for which application is made and I
<br /> comply with the State Contractors Law 18.27 RC W and 296.200 WAC.
<br /> City of Everett Official Use Only
<br /> PERMIT#
<br /> 4/ E n-o 5 - 0c0C,
<br /> Own uthorized t Signature Date (Revised 9/23/2016J
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