3020 RUCKER AVE SNO CO HEALTH DISTRICT 2018-02-23

47-7- ELECTRICAL PERMIT APLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 I FAX 425-257-8857 1 (E) everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: () © k Li`-t4.5 BUILDING AREA(if residential, new construction, remodel,or addition) SF BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 17.1'65MMERCIAL USE OF BUILDING: ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ I� ZOO NUMBER OF DEVICES (if low voltage): FIRE ALARM? 0 YES CNO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: r X r6 M f41 3 /1.D V C.ire u 7 TS F_c iA rt iTy lAA hELS CONTACT INFORMATION OWNER NAME: LA)D fa pill-1,514 rt-1 '‘.I°1TENANT NAME(If Commercial): Jdt OWNER MAILING ADDRESS: STREET ..:/L).1.D le 14C"2 A .5A!T!£ 308 �/ 7 CITY !F V rt ie 11 J STATE N./ i' ZIP ( V )a I OWNER PHONE: 5 -1 7 - 331- t 1S- OWNER EMAIL: j i 044P/11 14 k S O H ✓3, Oat-- CONTRACTOR aGCONTRACTOR NAME: ; )40L eLi e-re zL CONTRACTOR ADDRESS: STREET 3q LI MG 00,44,talc Av.z_ CITY /�rrr STATE k /4 r ZIP 9 r CONTRACTOR PHONE: t Z i'017 - /7 OD CONTRACTOR EMAIL: 41J t evG 1 �► X144. /t /cc tv,t . C CONTRACTOR LIC.#(REQUIRED): 041-IL 1 ' ZC A O CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 03 lo a�( PRIMARY CONTACT: 0 OWNER g-C6NTRACTOR ❑OTHER(Please Specify) CONTIT NAME: CONTACT PHONE: '1(�(�- 4 G 1 - Q S , i S 7e..! S CONTACT EMAIL: ‘1 Stever,, (14,4 le pec. AGREEMENT:T hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and 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 I 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. City of Everett Official Use Only FEE PERMIT# E (1, oP)- I?�1 Owner/Authorized Agent Signature Date (Revised 10/12/2.015)