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05/10/2018 20:07 FAX 425 377 1976 REX ELECTRIC L1001 <br /> ELE <br /> �■CTRICAL PERMIT APPCATION <br /> �►� , , CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 1 (E)everetteps(everettwa.gov I www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION ..—• <br /> PROJECT ADDRESS: 10 Uk ` • n t, r <br /> BUILDING AREA 01 residential,new construction,remodel,or addition) SF �f - . <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: _ )(COMMERCIAL <br /> USE OF BUILDING; li....1A-ffge V OV--- CO f/' /7G 6.---) <br /> ELECTRICAL APPLICATION INFORMATION --..– <br /> CONTRACT PRICE OF WORK:$ (f)—ai00 "- . <br /> _NUMBER OF DEVICES(if low voltage . <br /> FIRE ALARM? a YES 0 NO <br /> ASSOCIATED BUILDING PERMIT#(f applicable): <br /> DESCRIPTION a WORK: °XI _Az I ' .. I std.... .A. s A.C' ' - <br /> il P ACI <br /> - <br /> -w <br /> .� w� CONTACT INFORMATION <br /> OWNER NAME: W t A.UI\v J i i •Q _ TENANT NAME If Commer lel : IA /. ' ' ..A.: <br /> OWNER MAILING ADDRESS: STREET _ 0 ) j` f n ' <br /> TT/^� CITY i LC 1 <br /> OWNER PHONE: �1J ' OWNER EMAIL: �� ii !. ' �'b/e) <br /> CONTRA • : , • ,, • : - - - : r : I , <br /> CONTRACTOR ADDRESS; 11112 18th ST NE <br /> Lake Stevens WA 98258 -_ - STALE ZIP ., <br /> CONTRACTOR PHO E: 425 • 2-17 CONT- •CT e R EM• IL: rri. ks ci .mail. om <br /> CONT;.CTO- ,IC. _ R . _ELES• •2N4 CITY OF EVERETT BUSINESS LIC.#048749 <br /> PRIMARY CONTACT: Edi OWNER 0 CONTRACTOR 0 OTHER(Please Specify) - <br /> CONTACT NAME:Robin Riecks CONTACT PHONE :426-422-1744 <br /> CONTACT EMAIL:rriecks@gmail.com <br /> 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 <br /> 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 provision$of any other state or <br /> 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 <br /> comply with the State Contractors Law 18.27 RCW and 208.200 WAC. <br /> City of Everett Official Use Only <br /> FEE <br /> PERMIT# <br /> 1 <br /> .-(7)1(y <br /> 1,,,kt— 51/o/zoie Et €60 -rpil-1 <br /> Owner/Authorized Agent Signature Data (Revised 10/12/2015) <br />