3125 COLBY AVE COLBY PROFESSIONAL CENTER 2019-12-31

SECTRICAL PERMIT AOLICATION 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 PROJECT ADDRESS: S V E BUILDING AREA(if residential, new construction, re4odel, or addition) SF BUILDING TYPE: ❑ SFR-DETACHED ❑ SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: COMMERCIAL USE OF BUILDING: AcrtUz"5 I C'e—'a ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ 50a U NUMBER OF DEVICES (if low voltage): FIRE ALARM? ❑YES NO ASSOCIATED BUILDING PERMIT# (if applicable): DESCRIPTION OF WORK: C�ISSC. w ,�N /ft✓ G " 2vt UO (, rT CONTACT INFORMATION OWNER NAME: TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET CITY �(/� STATE U10?P ZIP 182 OWNER PHONE: .�JFJ� -_ ` 8 Ej)G" JOWNER EMAIL: CONTRACTOR NAME: /f2�. �Gc-¢✓� Lr(C� CONTRACTOR ADDRESS: STREET�r 13L)/`Gil s��/ CITY /Tt./ / STATE ZIP CONTRACTOR PHONE; ,�;'Q-_, 79& 9/ 7 CONTRACTOR EMAIL: _"Le CONTRACTOR LIC.#(REQUIRED): C'L&cTS-', 0,7?CGc CITY OF EVERETT BUSINESS LIC.#(REQUIRED): PRIMARY CONTACT: KOWNER ❑ CONTRACTOR ❑ OTHER(Please Specify) CONTACT NAME:/ Cc� �Z — CONTACT PHONE: �� �-✓ J CONTACT EMAIL: 1�G1'—/(C GLC Cr�jC�jG�C /Uh; Ike- AGREEMENT T 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 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 local law regulating construction or the performance of construction. That I 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 18.27 RCW and 296.200 WAC. City of Everett Official Use Only FEE 9 PERMIT# El -- - OwnerlAuthorized Agent Signature Date (Revised 1 0/1 212 0 1 5)