1925 LOMBARD AVE 2016-05-24 - Laserfiche WebLink

., _ _ u,r. ifiLEGTRIcAL PERVIIIT A UCA ION . ''(*S. -4 . vii0 CITY OF EVERETT PERMIT SE VICES 3200 CEDAR STREET, EVERETT, WA 98201 (P) 425-257-8810 I FAX 425-257-8857 1 (E) everetteps@everettwa.gov I www.everettwa.gov/permits T_____ PROJECT SITE INFORMATION PROJECT ADDRESS: I q 3- LoI'Y4 G( i2 D AVL E V X29-'+.1- l-c,A- c/ 8 v BUILDING AREA(if residential, new construction, remodel,or addition) kf-+'+1-0 d-t C— SF BUILDING TYPE: 0 SFR-DETACHED 0 SFR ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL USE OF BUILDING: ' ELECTRICAL APPLICATION INFORMATION • CONTRACT PRICE OF WORK:$ ,2. 7 0 0 NUMBER OF DEVICES (if low voltage): FIRE ALARM? ❑YES IS/NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: t h 54cr./I A&€ )-v v /v mre;(I/ ( -7?./ I p -1 C i , aUt z u n c2 /-/, R 4';. rz c i +- S /I CONTACT INFORMATION OWNER NAME: K ,t 11 Ji 5 6 k (-( /p CTTENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET CITY STATE ZIP OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: V T .- iL E i_G C eG c_ CONTRACTORADDRESS: STREET ,S 7 O 7 / 72 k' 5 t 477 Pj o-+- -Q II CITY I-L. ' A STATE I S C /oL ZIP CONTRACTOR PHONE: (-1 a_c) b+tr q/CONTRACTOR EMAIL: CONTRACTOR LIC.#(REQUIRED): V '7- G 1< c---_-' e C V t,K1CITY OF EVERETT BUSINESS LIC.#(REQUIRED): PRIMARY CONTACT: ❑ OWNER V. CONTRACTOR ❑ OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: ; r ,G% 7) CONTACT EMAIL: AGREEMENT:T hereby certify that I 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 lam 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 FEE PERMIT# I E 1 t3 - a1 Owner/, orized '.ent Signature Date (Revised 10/1212015)