2619 RUCKER AVE 2019-04-16 - Laserfiche WebLink

4:77- ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 I (E) everetteps@everettwa.gov[ www.everettwa.gov/permits PROJECT.SITE`INFO T O .......... .. RMA 1 N ... ;.. PROJECT ADDRESS: eQ(c-N 1 G LA& 'P Y— PrikeJ BUILDING AREA(if residential, new construction, remodel,or addition) in 43 SF BUILDING TYPE: 0 SFR-DETACHED 0 SFR ATTACHED 0 DUPLEX Al MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL i USE OF BUILDING: ;::;:'::::.:::; :::;;:::::ELECTRICAL:APPLICATIONaNFORMATION CONTRACT PRICE OF WORK:$ LOP-0 .qi O NUMBER OF DEVICES (if low voltage): FIRE ALARM? 0 YES 0 NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIIPTION OF WORK: V/Z-}a 5 hPte" 4-- Drt1 edit` rZe c capid es ,/1 Pi c CONTACT INFORMATION OWNER NAME: ( ' C CU, TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET f K.Lk `-e/r- /-}I e CITY ll) STATE "' ZIP 0�} OWNER PHONE: — J' )of _5-36 OWNER EMAIL: d Gi'r t t. ` 9 (�n..,�., , Can-) J CONTRACTOR NAME: G&S HEATING CONTRACTOR ADDRESS: STREET 3409 EVERETT AVE cITY EVERETT STATE WA ZIP 98201 CONTRACTOR PHONE: 425-252-4402 CONTRACTOR EMAIL: DAWN@GSHEATING.COM CONTRACTOR LIC.#(REQUIRED: GSHTGSH93ORK CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 019685 PRIMARY CONTACT: ❑OWNER 17 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 425-252-4402 DAWN WEIMER CONTACT EMAIL: DAWN@GSHEATING.COM AGREEMENT:I 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 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 properly to perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200 WAC. (17 City of Everett Oficial Use Only PERMIT* EMOR 3 Owner/Authorized Agent Signature Date (Revised 9/23/2016)