1001 RUCKER AVE 2019-04-30 - Laserfiche WebLink

ifililliPice- ELECTRICAL PERMIT APPLICATION _J ,.. 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 everettwa.gov I www everettwa.govlperritits PROJECT SITE;INFORMATION PROJECT ADDRESS: l 0 C \ ,.I .G ` BUILDING AREA(if residential,new construction,remodel,or addition) SF BUILDING TYPE: IG!- e-SFR-�DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY #OF UNITS: ❑COMMERCIAL USE OF BUILDING: 'K-.- -,6.. v\ ELECTRICAL APPLICATIONNFoRifIATION CONTRACT PRICE OF WORK:$ IT), oCK- "" NUMBER OF DEVICES(if low voltage): FIRE ALARM? D YES 0 NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: 4 `r. 6,. k ,; -- :tec� t n :.. c , ..a-,a) i d4 * -.0.,..;ni SnAct,,- ei ." k-c_ 4- 3 Cjt7L.44_C Cc cu.):4- { 4 CAA r A n e a CONTACT INFORMATION OWNER NAME: t" .V - 5,5..e.{\ TENANT NAME(If Commercial): OWNER MAILING,ADDRESS: STREET O1/4„ crry STATE ZIP OWNER PHONE: 20 C-` t ct- «t(.e (,p OWNER EMAIL: CONTRACTOR NAME: DZ-Cit.- tt. (vi 4. 'b G tC Y".c.-, Y,C...r CONTRACTOR ADDRESS: STREET )v4 g t (/J� jJ CITY 9\ + k STATE iA. �z b G CONTRACTOR PHONE:1 '-7-I - I t CONTRACTOR EMAIL: c$r 5t t .rive i r e:onr tc i .. Lam, CONTRACTOR LIC.#(REQUIRED): " C. „ -j ,. 13 atatk. CITY OF EVERETT BUSINESS LIC.#(REQUIRED): Iiq' t. y PRIMARY CONTACT: 0 OWNER Mr-CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: avvy\t`-`..v. ..e ,d {" o C i CONTACT EMAIL: 5,e2-t e vti- t t' � cc t$ , Ck5yi AGREEMENT:I hereby certify that I have read and examined this application and know the same to be tare and All provisions ws 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 otherstate or local law regulating constriction or the performance of construcfron. That I am authorized by the owner of this property to;perform the work for which application is made and l comply with the State Contractors Law 1a27 RCW and 296.200 WAC. City of Everett Official Use Only PERMIT# • 11VPlititt. `1 .1a- '(i- , E t -7 ( 0 -003 Own r uthorizere Date (Revised 9123/2016)