4920 RUCKER AVE 2018-01-04 - Laserfiche WebLink

� � �� I� ��I�� 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 INFARMAI"ION PROJECTADDRESS: � zC� u� " '�� BUILDING AREA(if residential, new construction, remodel, or addition) SF BUILDING TYPE: ❑ SFR-DETACHED �FR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: ❑ COMMERCIAL USE OF BUILDING: �L 5��C C ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ ;�i'.. ;�i NUMBER OF DEVICES (if low voltage): FIRE ALARM? ❑YES .,�NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: �� '` �,J ,�. % L i..(;'J — -v2c:�l.vt 1��l� 1 GVS - t'�- � � � �i i-G�+-� S l I--��L..- 17.v�-(f - �x�,�� 5 G� �4 ��2�-� ��-P ��-� �"2>t�� c�2c.�� CONTACT INFORMATION OWNER NAME: TENANT NAME(If Commercial): OWNER MAILING ADDRESS: sTREET cirr sTarE ziP OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: }� QE� G�ZL�S�-i / CONTRACTOR ADDRESS: sTREET � � �-.� CITY /(J�� STATE ZIP _4j�: CONTRACTOR PHONE: � -�'C � �Z76 CONTRACTOR EMAIL: �(� ri'� ,�-yLT `G" . � LZ G��-1-C-.�O�K CONTRACTOR LIC.#(REQUIRED): �vj V� �'� CITY OF EVERETT BUSINESS LIC.#(REQUIRED): �% �7� PRIMARY CONTACT: ❑OWNER ❑ CONTRACTOR ❑OTHER(Please Specify) CONT CT NAME: � +„/� i�-� CONTACT PHONE: Z�-�ZL}-- I� U� d� � (�tJ� �(�� CONTACT EMAIL: �, � ��'j ZC(��(��.CGLLt AGREEMENT:1 hereby certify that 1 have read and examined this application and know the same to be true and co�rect. All provisions of laws and ordinances governing this type of work will be completed whether specifred herern 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 l am authorized by the owner of this property to perform the work for which applicatron rs made and I comply with the Stafe Contractors Law 18.27 RCW and 296.200 WAC. Ciry of Everett Offrcial Use Only PERMIT# �� c � f� � � �t�� —� � � .� Owner/Authorized Agent Signature D e (Revised 9/23/2016)