Laserfiche WebLink
,-.A ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 1 FAX 425-257-8857 1 (E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> ,2s--447,73-':,,,,:::,:---' <br /> PROJECTSITE INFO RATION i ' <br /> PROJECT ADDRESS: 2623 Rucker Ave. <br /> BUILDING AREA(if residential, new construction,remodel,or addition) SF <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: Temporary power pole (move service from house to be demolished) <br /> ELECTRICAL.APPLIcATEON`INFORMATION <br /> CONTRACT PRICE OF WORK:$ <br /> NUMBER OF DEVICES (if low voltage): <br /> FIRE ALARM? 0 YES 0 NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): D1803-002 <br /> DESCRIPTION OF WORK: Moving service from house to temp power pole <br /> CONTACT INFORMATION <br /> OWNER NAME: Deb Dickason TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 10925 W Lake Joy Dr NE <br /> C,TY Carnation STATE WA ZIP 98014 <br /> OWNER PHONE: 206 327-0208 A OWNER EMAIL: debdickason@yahoo.com <br /> CONTRACTOR NAME: t7 IV E-P---- <br /> CONTRACTOR ADDRESS: STREET <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> CONTRACTOR LIC.#(REQUIRED): CITY OF EVERETT BUSINESS LIC.#(REQUIRED): <br /> PRIMARY CONTACT: ®OWNER 0 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 425 877-8454 <br /> Mike Leonetti CONTACT EMAIL: mikeleonetti@gmail.com <br /> AGREEMENT:I 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 <br /> 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 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 296.200 WAC. <br /> \ City of Everett Official Use Only <br /> PERMIT# <br /> I►;,�- /25/2018 E ( 03 -/..5--q <br /> owner/Authoriz-i Agent ignature Date (Revised 9/23/2016) <br />