4502 RUCKER AVE 2022-02-23 - Laserfiche WebLink

'lip" &ECTRICAL PERMIT APPLICATION ,.--,- CITY OF EVERETT PERMIT SERVICES viiii3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 1 FAX 425-257-8857 1 (E)everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: .-6 5-01 k t m-kQ( AC BUILDING AREA(if residential,new construction,remodel,or addition) • SF - BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: USE OF BUILDING: Ct,N,{'Cy� ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK:$ i) 000 NUMBER OF DEVICES(if low voltage):, FIRE ALARM? 0 YESlO ASSOCIATED BUILDING PERMIT#(if applicable): N 441 / DESCRIPTION OF WORK: 2j c1 5 C( P u� yl- / /,Y ( Qom_ l O^-d5�=- G i {/L //1-e . �ZP,�(/vt-c9J�- fid.j f/0 - r c1 (,c,kr1- CONTACT:INFORMATION OWNER NAME: TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET CITY STATE ZIP OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: Pig CoV�s V e......1/4.. d. . . .,Lep,".44- .01v ,. CONTRACTOR ADDRESS: STREET I5 O GY`r,�e,�F2v-r3�Cn ek). I t rr�J CITY Sl,0 �J 1 STATEAt ZIP CONTRACTOR PHONE: 1-{766 "NO (Q (w( 7 CONTRACTOR EMAIL: M .* 501,AG d c P IVI.AU.), (per CONTRACTOR LIC.#(REQUIRED): CO m & �1 46630-2_, CITY OF EVERETT BUSINESS LIC #(REQUIRED): 2 7 r ! 7 PRIMARY CONTACT: ❑OWNER XONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: LIA j 76 � Coy -t c 6 /q -7 MN-4 S V f/� CONTACT EMAIL: G ?c ®u /—d' e) GPS)► ' - � AGREEMENT.-T hereby certify that I have read and examined this application and know the same to be true and correct. All provisions oflaws and 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 violate or cancel 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 WAG City of Everett Official Use Only FEE UQ2.' .....• / i _ PERMIT# 7 57/ > y _E t$05-• 1100 Owner/Authorized Ag t Signature Date (Revised 10/12/2015)