1015 LOMBARD AVE 2016-08-08 - Laserfiche WebLink

LECTRICAL PERMITCLIC ATION CITY OF EVERETT PERMIT VICES 3200 CEDAR STREET, EVERETT,WA 98209 (P)425.257-8890 j FAX 425-257-8857 ] (E) everetteps@everettwa.govwww.evereftwa.gov/permits PROJECT ADDRESS: Q car M 6 BUILDING AREA(if residential, new construction, remodel,or addition) Z1 0o SF BUILDING TYPE: lj�SFR-DETACHED ❑SFR ATTACHED ❑DUPLEX CI MULTI-FAMILY-#OF UNITS: ❑ COMMERCIAL USE OF BUILDING: Q lrvlT� i.T[ lE� ➢21�fL.AP P�:Q.��Tll®6� fl>�9FOlI�I tI �a�>f�' .. . ..IES 'i' ... . ._. ..,. ,. ......: _.. CONTRACT PRICE OF WORK:$ ono NUMBER OF DEVICES (if low voltage). FIRE ALARM? ❑YES -Et NO ASSOCIATED BUILDING PERMIT##(if applicable): DESCRIPTION-OF WORK: -t s :4' - - z. CONTACT INIFORMATlON civvNER NAME: 1 � TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET Q� Cly STATE ZIP OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: CONTRACTOR ADDRESS: STREET 7— S5T- G� CITY STATE ZIP l� CONTRACTOR PHONE: 14Z57 CONTRACTOR EMAIL: CCA'ra1s't_-J", CONTRACTOR LTC.#(REQUIRED): (9UZ�l 3�� CITY OF EVERETT BUSINESS LIG.#(REQUIRED): OJ 33 3 PRIMARY CONTACT:Y'�W_bWNER ❑CONTRACTOR L7 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: i {'Z5 42� -5 3067 G CONTACT EMAIL: -{i)1ev,r4eke C k-/'t C�Cd�"�``3`�'►^� AGREEMENT. Thereby certhythat 1 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 whetherspeclf'ed herein ornot. The granting of a permit does notpresume to give authorify to violate or cancel the provisions of any other state or local lawregulatfng construction orthe performance ofconstruction. That I am authorized bythe owner ofthis propenyto perform the work forwhich application is made and I comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City ofEveretf Official Use Only FEE 0 PERMIT# I b Owvned orize Age gnat Date (Revised 10/12/2015)