3102 RUCKER AVE 2017-07-10 - Laserfiche WebLink

LECTRICAL PERMIT A�rLICATION 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 PROJECTADDRESS: ;�iP�� E�L��C;�`�' ,�-L:� �1�1L f�E_- i% �,'�/�� BUILDING AREA(if residential, new construction, remodel,or addition) SF BUILDING TYPE: ❑ SFR-DETACHED ❑ SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: ❑ COMMERCIAL USE OF BUILDING: ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ �C✓i, c`' NUMBER OF DEVICES if low voltage): Z �- I\�CL/j( S FIRE ALARM? ❑YES ❑ NO ASSOCIATED BUILDING PERMIT# (if applicable): DESCRIPTION OF WORK: p/ow,v(r O y�a„� S� ,,, ,�,,,. ,v ;-y 70 !�� N7 0� w,/kY iE P.�nl�j°a.O (�2.��Ft�7 CONTACT INFORMATION OWNER NAME: �NoRS�iv FA,�n��Y t�L TENANT NAME(If Commercial): �b S7 7/ �cJ OWNER MAILING ADDRESS: sTReer P•O• Qoyc ��9� CITY ST/�1N W OO{�J STATE �1/'A ZIP ��29 Z OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: �IF.97N No�27NWEST CONTRACTOR ADDRESS: s-rREE �1Z7 S `�6¢�' S�QFE 7' CIN SF9��E STATE �fJ ZIP /��OO CONTRACTOR PHONE: �oG 62.� 3/Do CONTRACTOR EMAIL: ��"rs�en h� hea�'�✓►o�-�'tir.v�s�_t,o,,n CONTRACTOR LIC.#(REQUIRED): /�/E�9 Te�/N�9jf r�'� CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 64- /6/, PRIMARY CONTACT: ❑ OWNER f,� CONTRACTOR ❑ OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: �o�; 623 3/O a QCj��.�� s�� CONTACT EMAIL: �r � I,� / �r�� CQ7'+it a!�� taiC'S?.Ca�►-� AGREEMENT:T hereby certify that I have read and examined this applicafion and know the same to be true and correct. All provrsions of laws and ordinances governing this type of work will be completed whether specified herein or not. The granting of a permif 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 1 comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only FEE � ��" ��j� PERMIT# �-3,.,� Ea � �� — I �� uthori ignature Date (Revised 10/12/2015)