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0477 ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 1 FAX 425-257-8857 1 (E)everetteps@everettwa.gov 1 www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: 1205 Craftsman Way, Dock H, Slip #H-00 <br /> BUILDING AREA(if residential new construction,remodel,or addition) N/A SF <br /> BUILDING TYPE: 0 SFR-DETACHED ❑SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS 0 COMMERCIAL <br /> USE OF BUILDING: Boat Slip <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK:$ 700.00 <br /> NUMBER OF DEVICES(if low voltage): 1 <br /> FIRE ALARM? 0 YES RI NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: Installation of a shore power outlet to the existing power pedestal, required by the Port of Everett <br /> CONTACT INFORMATION <br /> OWNER NAME:Rob Rothe TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREw-300° Northrup Way, Suite 101 <br /> Bellevue S-ATEWA ,,,98004 <br /> 425-922-7304 ntellOhady( TrOntl <br /> OWNER PHONE: OWNER EMAIL: or r•-nm <br /> CONTRACTOR NAME: W E Electric <br /> CONTRACTOR ADDRESS: STREET PO Box 2427 <br /> c,T,Redmond STATE WA zi, 98073 <br /> CONTRACTOR PHONE:425-508-6382 CONTRACTOR EMAIL: ruth.wyatt@weelectric.com <br /> CONTRACTOR LIC.#(REQUIRED): WEEI-EEE91 04U CITY OF EVERETT BUSINESS LIC.#(REQUIRED):57075 <br /> PRIMARY CONTACT: 0 OWNER {2 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 425-508-6382 <br /> Ruth Wyatt CONTACT EMAIL:ruth.wyatt@weelectric.com <br /> AGREEMENT:I 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. <br /> City of Everett Official Use Only <br /> PERMIT# <br /> E 0- O <br /> Owner/Authorized Agent Signature Date (Revised 9/23/2016) <br />