1005 RUCKER AVE 2019-04-30 - Laserfiche WebLink

01/10/2018 14:38 #3091 P. 002/002 ELECTRICAL PERMIT APPLICATION1!!!!!IL - • CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 • (P)425-257-8814 I FAX 425-257-8857 I (E) everetteps@everettwa.gav I www.everettwa.gov/permits • PROJECT SITE INFORMATION ' PROJECT ADDRESS:IOOS BUILDING AREA(if residential, new construction,remodel,or addition) _ SF BUILDING TYPE: ❑SFR-DETACHED ❑ SFR-ATTACHED' ID DUPLEX L7 MULTI-FAMILY.#OF UNITS: ❑COMMERCIAL USE OP BUILDING: _ter ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK:$ -521f, _ NIJMi3ER OF DEVICES(If low voltape): FIRE ALARM? 0 YES Q NO ASSOCIATED BUILDING PERMIT# if a•.licable : DESCRIPTION OF WORK: &a/904-6 p CONTACT INFORMATION OWNER NAME: N/111-0,U f/' /, I _ TENANT NAME(If Comrnercial): OWNER MAILING ADDRESS: sTREEr 0# —' i4 • CnY /EPL T STATE ZIP W OWNER PHONE: ' 2/ • /t OWNER EMAIL: CONTRACTOR NAME: CC • /K # u( 5 � CONTRACTOR ADDRESS: STREET 3fe 10 r E •'# ,„, STAT= � • ZIP 1�hLJ CONTRACTOR PHONE: yz.r .2$r% 2/ / CONTRACTOR EMAIL: CONTRACTOR LIC.#(RcQuiREO): 5k- /(/.� /1/2-4J9 CITY OF EVERETT BUSINESS LIC.#(REQUIRED): PRIMARY CONTACT: Q OWNER 0 CONTRACTOR 0-OTHER(Please Specify) inf 6 CONTACT NAME: CONTACT PI-ION1=: Y4-r y/ Al T b C) CONTACT EMAIL: AGREEMENT t hereby certiy that t 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 property to perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only 1 PERMIT# • l �� lam. E t � L} Ow ,r/Authorized Agant Signature to (Revised 9/23/2016)