1125 RUCKER AVE 2019-04-30 - Laserfiche WebLink

0011111111110. - :ECTRICAL PERMIT Al —JCATi•N 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 www.everettwa.govlpermits 'PROJECT ADDRESS: //ZS &e-- 'r, ,4Ve- 'BUILDING AREA(if residential,new construction,remodel,or addition) //DU SF ;BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL USE OF BUILDING: S,n j i FaM �esreki!e:e - ELECTRICAL APPLICATION 9: FORMATION n� CONTRACT PRICE OF WORK:$ 7'7W _ NUMBER OF DEVICES(if low voltage):• f FIRE ALARM? ❑YES Pl NO ASSOCIATED BUILDING PERMIT#(if applicable): ----"'! ' -.bl DESCRIPTION OF WORK: ?i > e,c.,.?1 rr- CONTACT INFORMATIOie1.:: OWNER NAME: J arksC -7-11 0 lt j TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET ,.Ur+1 C. 1 Cm! L ph) ZIP OWNER PHONE: ZO6 ` 588 6 29 OWNER EMAIL: � Z. Sea–EI. le nh)pnbGc 3 )/:1 >. .. _ CONTRACTOR NAME: JO+r f e 4 i e,y-4-P e s',.., s"t t..) tt4 ,l.t.0-C t c t CC CONTRACTOR ADDRESS: STREET SISf- CITY(::::I/p/rit. STATE yy� ZIP CONTRACTOR PHONE: L-iZS W 232--74 b7 CONTRACTOR EMAIL: JASe� e /�'yS10zTG H tI Eft c .ed,)1 CONTRACTOR LiC.#(REQUIRED): S W =TGE I- ''i I(5 PK CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 0 62 5 S7 PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME:�D c CONTACT EMAILCONTACT : �2 5.r 2 3 z - -7 L�h7 AGREEMENT:T hereby certify that/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/am authorized by the owner of this properly to perform the work for which application is made and I comply with the State Contra ors Law = • -..296.200 WAC. it•A 1111 City of Everett Official Use Only FEE w tG , PERMIT# O i................_ El� ` ,;_ DOI Owner/. . orize ��:: tSignature Date (Revised 10/12/2015)