2702 COLBY AVE PEOPLES BANK 2021-04-20

�CTRICAL PERMIT AF _ICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P) 425-257-8810 � FAX 425-257-8857 � (E) everetteps@everettwa.gov � www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: �I V� 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: I ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ lD (�---� NUMBER OF DEVICES if low volta e : FIRE ALARM? ❑YES ❑ NO ASSOCIATED BUILDING PERMIT# (if applicable): DESCRIPTION OF WORK: CONTACT INFORMATION OWNER NAME: � L TENANT NAME(If Commercial): OWNER MAILING ADDRESS: srREe-r CITY STATE ZIP L/ !i'v . OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: l Z CONTRACTOR ADDRESS: srREeT o �C� CITY � STATE ��-- ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LIC.#(REQUIRED): � CITY OF EVERETT BUSINESS LIC.#(REQUIRED): ZY� PRIMARY CONTACT: ❑ OWNER CONTRACTOR ❑ OTHER(Please Specify) CONTACT NAMF� CONTACT PHONE: � �� CONTACT EMAIL: � G �Si � _I AGREEMENT:T hereby certify that/have read and examined this app/ication and know the same to be true and correct. All provi�ons o laws n 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 vio/ate or cance/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 I comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only FEE � �da PERMIT# �� E � �D�J�� Owner/Authorized Agent Signature Date (Revised 10/12/2015)