Laserfiche WebLink
PUBLIC WORKS PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> OL 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P) 425-257-8810 FAX 425-257-8857 1 (E) everetteps@everettwa.gov www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS:3025 LOMBARD AVE <br /> IF APPLICABLE: = LAND USE PROJECT#(SEPA, PRE-APP, SS, ETC.) <br /> SITE WORK FOR PROJECT TYPE: =SFR-DETACHED ©SFR-ATTACHED =DUPLEX =MULTI-FAMILY =COMMERCIAL <br /> CHANGE OF USE? = NO [--] YES, FROM TO <br /> NEW WATER/SEWER SERVICE NEEDED? = NO = YES,TYPE SIZE <br /> SITE WORK 1 RIGHT-OF-WAY APPLICATION INFORMATION <br /> DESCRIPTION OF WORK: MCI Metro Franchise Permit#1801AUJE.1 ROWI EVT 0951 <br /> INSTALLATION OF 1348 LF OF STRAND, (7)ANCHORS & PULL FIBER CABLE IN THE RIGHT-OF-WAY OF MCDOUGALL <br /> AVENUE, WALL ST, AND LOMBARD AVE. <br /> = CUTBORE IN PAVEMENT(PARALLEL) LF <br /> = CUT/BORE IN PAVEMENT(NON-PARALLEL) LF <br /> CONTACT INFORMATION <br /> OWNER NAME: CITY OF EVERETT <br /> OWNER MAILING ADDRESS: STREET 3200 CEDAR ST <br /> CITY EVERETT STATE WA zip 98201 <br /> OWNER PHONE: OWNER EMAIL: <br /> APPLICANT NAME: Arnaldo Blanco <br /> APPLICANT MAILING ADDRESS: STREET 3000, E Cesar Chavez St. <br /> CITY Austin STATE TX ZIP 78702 <br /> APPLICANT PHONE: 7873492960 APPLICANT EMAIL: ablanco@fg-inc.net <br /> PRIMARY CONTACT: = OWNER CI APPLICANT = OTHER(Architect, Engineer, Etc.) <br /> CONTACT NAME:AARON LEDVINA CONTACT PHONE:2067156372 <br /> CONTACT EMAIL: aledvina@fg-inc.net <br /> ACKNOWLEDGEMENT.I have reviewed this application and confirm the information contained herein is true and correct. Work done pursuant to this permit must <br /> comply with current federal,state,and local law. The granting of a permit only authorizes approved work and no deviations therefrom. Deviations must first be <br /> authorized in writing from the Building Official before being authorized under any circumstance. I am the owner,or l am authorized by the owner of this property to <br /> perform the work for which application is made, and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> PERMIT# <br /> PW1905-019 <br /> ETRAKiTAPPLICATION RECEIVED 5/3/2019 (Revised 313012018) <br />