1527 RUCKER AVE 2019-11-07 - Laserfiche WebLink

ELECTRICAL PE MIIT APPLICATOCW CITY OF EVERETT PERMIT SERVICES W • 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 1 FAX 425-257-8857 1(E)everetteps@everettwa.gov 1 www.everettwa.gov/pormits PROJECT SITE INFORMATION PROJECT ADDRESS: be.e.,kcj2,_ -- BUILDING AREA(If residential,new construction,remodel,or addition) SF 'BUILDING TYPE: 0 SFR-DETACHED El SFR-ATTACHED El DUPLEX 0 MULTI-FAMILY #OF UNITS: 0 COMMERCIAL USE OF BUILDING: • ELECTRICAL APPLICATION ONFORMATI CONTRACT PRICE OF WORK:$ if NUMBER OF DEVICES(if low voltage): FIRE ALARM? EI YES EI NO ASSOCIATED BUILDING PERMIT#(If applicable): DESCRIPTION OF WORK: -C7/4Cfil.4" aA,s, tedaiii4( aer-1746/1-cc rvio4.14(.(A-ricv-15' . . „. . . • ' CONTACT INFoRm4vrioN • . .• OWNER NAME: 6A-tZ-fS 1.-A-14,L6c-cetQL4 TENANT NAME(If Commercial): OWNER MAILING ADDRESS: s•reEET 71 5 /4/-v1ti CITY sure ZIP OWNER PHONE: OWNER EMAIL: I•• . . .. . _ CONTRACTOR NAME: eliOte (.464--re 1-36/AT.- 11 CONTRACTOR ADDRESS: STREET '2170 roc}C:1-61c. cn'raicieeri STATE UM- ZP CONTRACTOR PHONENZS1 ZSI-3 CONTRACTOR EMAIL: CONTRACTOR LIC.#(REQUIRED): 4", e-A: 7 —/U CITY OF EVERETT BUSINESS LIC.#REQUIRED):(VrT155— PRIMARY CONTACT: Ei OWNER ICONTRACTOR OTHER(Please Specify) --- CONTACT NAME: CONTACT PHONE: .474 , 25%-3'// ç ( ) CONTACT EMAIL: eo, AGREEMENT':I hereby certgythat I have read and examined this application and know the same to being)and correct. AI 1 provisions of laws and ordinances governing this type of work will be completed whether specified heroin or not. The granting of a permit does not presume to glve authority to violate°roam&the provisions of any other state or focal law regulating construction or the performance of construction. That!em authorized by the owner of this property to perform the work for which applicetion is made and compty with the Stele Contractors Law 10.27 RCW and 296.200 WAC. City of Everett Official Use Only PERMIT# Owner/Authorized Agent Signature Date (Revised 9123/2-016)