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1308 RUCKER AVE 2018-06-27
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1308 RUCKER AVE 2018-06-27
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Last modified
6/27/2018 10:23:37 AM
Creation date
6/27/2018 10:23:37 AM
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Address Document
Street Name
RUCKER AVE
Street Number
1308
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I ECTRICAL PERMIT A (CATION <br /> I�►'� CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 I (E) everetteps@everettwa.gov f www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: /3 0e /. Ii CA La- A.V <br /> BUILDING AREA(if residential,new construction,remodel,or addition) r'0m Gu t...1 SF <br /> BUILDING TYPE:.gSFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK: $ 2 1©0 <br /> NUMBER OF DEVICES(if low voltage): <br /> FIRE ALARM? ❑YES *NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): No <br /> DESCRIPTION OF WORK: 7-A°STAti LL 1. S Tot CP 4-2-6)077s- <br /> 01- <br /> 077s- <br /> 01- 'iA.,c12_ LZ-6- , 7-7.r <br /> CONTACT INFORMATION <br /> OWNER NAME: /VID 214 A LeoER TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: sTRiEa3 C3gce ch An_ <br /> /Z L.A./Z.1 1r CITY STATE 1...4.-44ZIP <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: h <br /> CONTRACTOR ADDRESS: STREET P, 0. 8o '�.i i 7 <br /> CITY 'L �i � STATE ZIP 9 v <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> CONTRACTOR LIC.#(REQUIRED): DA.g.-C-'6,17415"' q70/1 A CITY OF EVERETT BUSINESS LIC.#(REQUIRED):6°16 I <br /> PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: c.�Z S- , Lj 2_ '7e' ti <br /> nig , y AJAX CONTACT EMAIL: c/ A ��e �.r:c.,6) <br /> AGREEMENT:T hereby certify that 1 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 provisions of any other state or <br /> local law regulating construction or the performance of construction. That/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 296.200 WAC. <br /> City of Everett Official Use Only <br /> FEE <br /> PERMIT# <br /> 6 /-7 E 17611 -1 0(,,,7 <br /> Owner/Authorized Agent Signet - Date (Revised 10/12/2015) <br />
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