1717 ROCKEFELLER AVE 2017-06-29 - Laserfiche WebLink

ELECTRICAL PERMIT APPLICATION CITY OF EVERETT P�RMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 � FAX 425-257-8857 ( (E)everetteps@everettwa.gov� www.everettwa.gov/permits PR JECT SITE INFORMATION PROJECT ADDRESS: �J BUILDING AREA(if residential,new construction,remodel,or addition) SF I�(7✓� BUILDING TYPE: ❑SFR-DETACHED ❑SFR-ATTACHED ❑DUPLEX MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL USE OF BUILDING: �� r Q ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK:$ � NUMBER OF DEVICES if low volta e : FIRE ALARM? ❑YES O ASSOCIATED BUILDING PERMIT if a licable : DESCRIPTION OF WORK: �"c.cr LJ � �// CONTACT INFORMATION OWNER NAME: W�r��✓� ✓1 TENANT NAME(If Commercial : /&'�'� OWNER MAIUNG ADDRESS: srkeeT �d� �. t�/+� �� O� CITY � STATE /" ZIP OWNER PHONE: � � �' 7`L " �( OWNER EMAIL: �/YI Bf CC17 Ci��'r'VI��Pi(,f1''r Ai�GOI� CONTRACTOR NAME:Rex Electric Service(nc. COfVTRE►CTOR ADDRESS: 11112 18th ST NE Lake Stevens WA 98258 STATE Z�P CONTRACTOR PHONE:425-422-1744 CONTRACTOR EMAIL: rriecks mail.com CONTR/►CTOR LIC.# REXELES962N4 CITY OF EVERETT BUSINESS LIC.#048749 PRIMARY CONTACT: � OWNER ❑CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME:Robin Riecks CONTACT PHONE:425-422-174d CON7ACT EMAIL:rriecks�gmail.com AGREEMENT:T hereby certify that l have read and examined this applicafion and know the same to be hue and correct. All provisions of laws and ordinances goveming this type of woik will be completed whether spec'died herein or not The gran5ng of a permit does not presume to give authorify to violate or cance/the provisions of any other state or local law regula&ng cronstruction or the performance of construction. That 1 am authorized by the owner of this property to perform the work for which applicafion is made and I comply with the Sfate Contractors Law 18.27 RCW and 296.200 WAC. City of Everett O�cial Use Only FEE � �� PERMIT# ' � Z�/7 E D�"'l�� Owner/Authorized Agent ignature Date (Revised 10/12/2015)