1725 RUCKER AVE 2017-01-13 - Laserfiche WebLink

�CTRICAL PERMIT AP�.ICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P) 425-257-8810 � FAX 425-257-8857 �(E) everetteps@everettwa.gov � www.everettwa.gov/permits PROJECT SITE INFORMATION ' ROJECT ADDRESS: I� Z� �-I/t G f vY � � i V"� " l UILDING AREA (if residential, new construction, remodel, or addition) SF UILDING TYPE: ❑ SFR-DETACHED �SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY -# OF UNITS SE OF BUILDING: ,l�it �/l �l(/�. g�Q�,�� ❑ COMMERCIAL OWNER NAME: C(,� J�[J(XV�U(iY OWNER MAILING ADDRESS: srREeT CONTACT INFORMATION TENANT NAME (If Commerc Ylv� CITY �/► V"1"( STATE �l ' j� OWNER PHONE: � �IZ"✓� �V V�"I �J � OWNER EMAIL: �v � CONTRACTOR NAME: � In �� ,� �,Q,(/ ��1 CF/�� /VV 1�S � I�,i/ • CONTRACTORADDRESS: sTREET ��JO l 1 Ith �� ciTv S S srarE V V� CONTRACTOR PHONE: �ZS� �� V��J CONTRACTOR EMAIL: �CGI I�VI,�� CONTRACTOR LIC. #(REQUIRED): I rI Y11)1/lr, �°�I G%� D�l� CITY OF EVERETT BUSINESS LIC. ZIP � V L� . � I �i u►� REQUIRE PRIMARY CONTACT: ❑ OWNER CONTRACTOR ❑ OTHER (Please Specify) ' CONTACT NAME: 1 i„ j CONTACT PHONE: ��2 1�� — �� eL��' �7� CONTACT EMAIL: S " (�� A GREEMENT: T hereby certify that 1 have read and examined this application and know the same to be true an correct. All provisi ns of laws a 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 1 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 WAC. nt Sfgnature Date City of Everett Otficial Use Only FEE �;a��,�� _ --- PERMIT # E ��o� � �� (Revised 10/12/2015)