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ELECTRICAL PERMIT APPLICATION <br /> 4111.1114 <br /> „ws4f0.. 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:10126 6th DR SE <br /> BUILDING AREA(if residential, new construction, remodel,or addition) SF <br /> BUILDING TYPE: ❑ SFR-DETACHED ❑SFR-ATTACHED ❑ DUPLEX D MULTI-FAMILY-#OF UNITS: ❑ COMMERCIAL <br /> USE OF BUILDING: <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK: $350 <br /> NUMBER OF DEVICES(if low voltage): <br /> FIRE ALARM? ❑YES ❑ NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: <br /> FURNACE CHANGE OUT <br /> CONTACT INFORMATION <br /> OWNER NAME: Jerry Colburn TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 10126 6th DR SE <br /> CITY EVERETT STATE WA ZIP 98208 <br /> OWNER PHONE:425-608-2672 OWNER EMAIL:Jacburn5@yahoo.com <br /> CONTRACTOR NAME: MM COMFORT SYSTEMS <br /> CONTRACTOR ADDRESS: STREET 18103 NE 68TH ST SE, C-200 <br /> c,;Y REDMOND STATE WA ZIP 98052 <br /> CONTRACTOR PHONE:425-881-7920 CONTRACTOR EMAIL:PERMITS@MMCOMFORTSYSTEMS.COM <br /> CONTRACTOR LIC.#(REQUIRED):MMCOMCS839PT CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 055245 <br /> PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:425-881-7920 <br /> J E NAH BARLOW CONTACT EMAIL:permits@mmcomfortsystems.com <br /> AGREEMENT:T hereby certify that/have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this <br /> 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 <br /> 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 <br /> comply with the State Contractors Law 18 27 RCW and 296.200 WA C <br /> City of Everett Official Use Only <br /> FEE <br /> 1(,J <br /> PERMIT# <br /> ( <br /> 1/22/2019I <br /> Owner/AuthorizedkAgent t'gnaturtf Date (Revised 10/12/2015) <br />