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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 1 (E)everetteps@everettwa.gov 1 www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS:12502 17th Ave SE <br /> BUILDING AREA(if residential,new construction,remodel,ar addition) SF <br /> BUILDING TYPE: 0 SFR-DETACHED ISFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK: $550 <br /> NUMBER OF DEVICES(if low voltage: <br /> & FIRE ALARM? 0 YES ❑_NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> t DESCRIPTION OF WORK: <br /> AC ADD ON <br /> CONTACT INFORMATION <br /> OWNER NAME. Rolland & Dianne Hofstedt TENANT NAME(If Commercial) <br /> OWNER MAILING ADDRESS:. sTREEr 12502 17th Ave SE <br /> OTv EVERETT STATE WA .zI . 9Pg93 _. <br /> OWNER PHONE:415 533 9159 OWNER EMAIL:rollycpa@outlook.com <br /> CONTRACTOR NAME MM COMFORT SYSTEMS <br /> 18103 NE 68TH ST SE <br /> CONTRACTOR ADDRESS: STREET ,C-200 <br /> ary 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. (RE= tIRED) - <br /> PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:425-881-7920 <br /> JENAH BARLOW <br /> CONTACT EMAIL:permits@mmcomfortsystems.com <br /> 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 <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 WAG. <br /> Cuy of Everett Official Use Only <br /> FEE <br /> * <br /> PERMIT# <br /> , � E \o' p - 22 <br /> Q1ilrr�i�ttA� -• " Date <br /> (Revised 10/1`2/2015J <br />