2801 LOMBARD AVE 2017-06-13 - Laserfiche WebLink

ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 FAX 425-257-8857 I (E)everetteps@everettwa.gov J www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS. ,?Q(� , v) BUILDING AREA(if residential, new construction,remodel, or addition) SF BUILDING TYPE: © SFR-DETACHED 0 SFR-ATTACHED © DUPLEX 0 MULTI-FAMILY-#OF UNITS OMMERCIAL USE OF BUILDING: Vl!O pr~ ELECTRICAL APPLICATION INFORMATION i CONTRACT PRICE OF WORK: $ jlf ( °OC) NUMBER OF DEVICES if law voltage): FIRE ALARM? CI YES "0 ASSOCIATED BUILDING PERMIT# if applicable): DESCRIPTION OF WORK: &r t I {` t-} A4LD 4v C` l COTACT INFORMATION OWNER NAME: u t e- 11ti- TENANT NAME(i#Commercial): V JQ Ig LZCJI OWNER MAILING ADDRESS: STREET } } gy CITY STATc TT ZF OWNER PHONE: Cly OWNER EMAIL: C ez Voc.u�L3• C9 t CONTRACTOR NAME: RI NJo c-c mc_,. CONTRACTOR ADDRESS: STREET 5u i-)C_ R CITY ( i} STR'E ZiP �j z 3 3 CONTRACTOR PHONE: C)-- 05 CONTRACTOR EMAIL: j94'L-C s< C C_• + CONTRACTOR LIC.#(REQUIRED): E tA f�v CITY OF EVERETT BUSINESS LIC.#(REQUIRED):05' & PRIMARY CONTACT: ❑OWNER CONTRACTOR ©OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 1t tt t' CONTACT EMAIL: AGREEMENT:Thereby certify that l have read and examined this application and know the same to be true and correct. Ail provisions of taws and ordinances governing this type of work will be completed whether specked 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 t am authorized by the owner of this property to perform the work for which application rs made and 1 comply with the State Contractors Law 18.27 RCW and 298.200 WAC- City of Everett Offictai Use Only FEE � C) - C ' PERMIT# E Ac)2 — G (� �Ier/A 0horized AgentSrqnature Date (Revised 1011212015)