3125 COLBY AVE COLBY PROFESSIONAL CENTER 2019-12-31

EOCTRICAL PERMIT APPWATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 1 FAX 425-257-8857 1 (E)everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECTADDRESS: `�\2 CQtib Q 'FVQY'-z—' BUILDING AREA(if residential, new construction, remodel, or addition) SF BUILDING TYPE: ❑ SFR-DETACHED ❑ SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: COMMERCIAL USE OF BUILDING: 1 ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ t,15-C7�(D NUMBER OF DEVICES if low voltage): N P[ __- FIRE ALARM? ❑ YES NO ASSOCIATED BUILDING PERMIT# (if applicable): DESCRIPTION OF WORK: _ il S r1SAaA` Z or, kApxcL r�li S , cel LA . Z- CONTACT INFORMATION OWNER NAME: _ TENANT NAME(If Commercial):C-(n\ OWNER MAILING ADDRESS: STREET C._.o\ CITY STATE ZIP OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: PCS 1r�L �1C1J Cq� hCr. CONTRACTOR ADDRESS: STREET CnY STATE ZIP �`•L)C� CONTRACTOR PHONE:C2� 2jFJ2--d CONTRACTOR EMAIL: CONTRACTOR LIC.#(REQUIRED): Pv��-G�SZ..Ul-SDF CITY OF EVERETT BUSINESS LIC.#(REQUIRED): PRIMARY CONTACT: ❑ OWNER KONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: �� i5 CONTACT PHONE: CONTACT EMAIL: AGREEMENT. Thereby certify(hat/have read and examined this application and know the same to be true and correct. Alt provisions of laws and ordinances governing this type of work will be completed whether specified herein or not, The granting of a permit does not presume to give authority to violate or cancet the provisions of any other state or local law regulating construction or the performance of construction. That 1 am authorized by the owner of this property to perform the work for which application is made and 1 comply with the State Contractors Law 16.27 RCW and 296.200 WAC. City of Everett Official Use Only FEE �'iiia � � a ✓e PERMIT# QwnertAuthorized A tnt gnature D to (Revised 10/1212015)