2707 COLBY AVE MOSS ADAMS 2017-08-10

ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 1 FAX 425-257-8857 I (E)everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: ' 76-7 Wo, b BUILDING AREA(if residential,new construction,remodel,or addition) SF BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX ❑MULTI-FAMILY-#OF UNITS: C$COMMERCIAL USE OF BUILDING: ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK:$ NUMBER OF DEVICES if low voltage): u FIRE ALARM? 0 YES k5F ASSOCIATED BUILDING PERMIT# if applicable): DESCRIPTION OF WORK: Lnc,, a i CONTACT INFORMATION OWNERNAMELM CD6LC, TENANT NAME(If Commercial): O OWNER MAILING ADDRESS: STREET 0.Z07p Il Od CITYto, STATE OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: (` ' CONTRACTOR ADDRESS: STREET L;n Cj Q CITY STATE z� CONTRACTOR PHONE:,L5& , ,1{1 CONTRACTOR EMAIL:'jjpnnotS e r "-_ CONTRACTOR LIC.#(REQUIRED): =/v CITY OF EVERETT BUSINESS LIC.#(REQUIRED): D'73 PRIMARY CONTACT: 0 OWNER ONTRACTOR G OTHER(Please Specify) CONTACT NAME;: CONTACT PHONE:�s�'��, 7 �.J a n h MS CONTACT EMAIL:D6n � c AGREEMENT:f hereby certify that t have read and examined this application and know the same to be tare and correct. All prove tons of la%s and ordinances governing this type of work M)l 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 t am aulhofized 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 PERMIT# tte►lAuth ze A ent Signature Date (Revised 9/23/2016)