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4/4"-r 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 www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: 1205 Craftsman Way, Dock H, Slip#H4 <br /> BUILDING AREA(if residential,new construction,remodel,or addition) N/A SF <br /> BUILDING TYPE: 0 SFR-DETACHED 0 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 0 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:Spark Vanwinkle TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: sat x2410 38th Street <br /> Everett CRY STATE WA ,98201 <br /> OWNER PHONE: 425-508-8871 OWNER EMAIL: Spark@StadiumflowerS.com <br /> CONTRACTOR NAME:W E Electric <br /> CONTRACTOR ADDRESS: STREET PO Box 2427 <br /> cn Redmond STATE WA zP 98073 <br /> CONTRACTOR PHONE:425-5508-6382 CONTRACTOR EMAIL: ruth.wyatt@weeIectric.Com <br /> CONTRACTOR UC.#(REQUIRED): WEELEEE9104U CITY OF EVERETT BUSINESS LIC.#(REQUIRED):57075 <br /> PRIMARY CONTACT: 0 OWNER 0 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 taws and ordinances governing this type <br /> of work will be completed whetherspecified 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 t am 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 113.27 RCW and 296200 WAC. <br /> City of Everett Official Use Only <br /> PERMIT# <br /> WU-A Owner/Authorized Ageibly1C% <br /> gnature Date (Revised 9/13/2016) <br />