3619 RUCKER AVE 2017-06-29 - Laserfiche WebLink

ELECTRICAL PERMIT APPLICATION 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 PROJECT ADDRESS: 36�9 RUCK2f 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: FII"2 Statl011 ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ 7212.00 NUMBER OF DEVICES (if low voltage): FIRE ALARM? ❑YES m NO ASSOCIATED BUILDING PERMIT# (if applicable): DESCRIPTION OF WORK: Fuel Card reader replacement and circuit modifications CONTACT INFORMATION OWNER NAME: Clty Of EVefett TENANT NAME(If Commercial): Flt'e Statlon #2 OWNER MAILING ADDRESS: sTReer 3200 Cedar St c,T., Everett srnre WA zia 98201 OWNER PHONE: 425-257-HJ20 OWNER EMAIL: CONTRACTOR NAME: IIIIIOVatIV2 EI2CtfIC, �IIC CONTRACTOR ADDRESS: srREEr P. O. Box 4399 cin, Everett sTa,re WA ZiP 98204 CONTRACTOR PHONE: 425-290-7803 CONTRACTOR EMAIL: gUllllal"p�IIIIIOVatIVE;-CleCtl'IC.COI'1"1 coNTRacTOR�ic.#�REQuiREo�: INNOVE1055KE CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 36HZH PRIMARY CONTACT: ❑OWNER �C7 CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 425-290-7HO3 Gunnar Petzold coNTacr Emai�: gunnar@innovative-electric.com AGREEMENT.I hereby certify fhat I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances goveming 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 cance/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 W,4C. City of Everett Official Use Only PERMIT# � `� �� E ��,�"�` �� Owner/Authorized Agent Signature Date (Revised 9/23/2016J