4410 RUCKER AVE 2019-04-17 - Laserfiche WebLink

06/16/2017 08:23 #2293 P. 001/001 /1r— 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 I ww v.everettwa:gov/permits PROJECT.SITE INFORMATION . PROJECT ADDRESS: Y V/0 taIJGx Kik t �BUILDING AREA(if residential,new construction, remodel,or addition) SF _ BUILDING TYPE: ❑SFR-DETACHED ID SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: CI COMMERCIAL USE OF BUILDING: /ZFCf 4 (.)A47 TRIIC • APPLICATICI I ORMATION • • . . • • CONTRACT PRICE OF WORK:$ Ii ROO .. NUMBER OF DEVICES(if low volt-to : FIRE ALARM? ❑YES 0 NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: �ISll1[� ►tel r/ It-t my� � — • CONTACT INFORMATION• - OWNER NAME: 7-40-rM FA-At tar /)/41/1(14.- TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET 5 y "twit OK: //'� a/}J CITY / . /,,. 7 STATE ZIP '/ />!J OWNER PHONE: OWNER EMAIL: yj��eJ p+ CONTRACTOR NAME: era A /a4L 44 ��•/�l� P CONTRACTOR ADDRESS: STREET 3 � / . . .A .; 1 CITY /lY —A,1r STATE ZIP 49: ;of CONTRACTOR PHONE: Y- () ? 'VA/ CONTRACTOR EMAIL: CONTRACTOR LIC.#VREQUIRED): /MiAN 3,f/se us,/ CITY OF EVERETT BUSINESS LIC.#RECUR;D): 9/ 7o PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: �j // CONTACT PHONE: 5I1 f 3/ 2Z It (� (/ Coti_maity CONTACT EMAIL: • 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 10 violate or canoe!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 comply with the State Contractors 1-ew 18.27 RCW and 298.200 WAC. City of Everett Official Use Only PERMIT# Owner/.— ' zed Agent Signature Date (Revised 9/23201.6)