1324 LOMBARD AVE 2018-07-18 - Laserfiche WebLink

ELECTRICAL PERMIT APPLICATION 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 P RO$I TsS' ORT!O :. PROJECT ADDRESS: ta02,4 tyt BUILDING AREA(if residential,new construction,remodel,or addition) SF BUILDING TYPE: aFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX ❑MULTI-MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL USE OF BUILDING: CONTRACT PRICE OF WORK:$ 3O .6° NUMBER OF DEVICES.jif low voltage): FIRE ALARM? 0 YES 0 NO ASSOCIATED BUILDING PERMIT#(if a Pfcable): DESCRIPTION OF WORK: .}rir ' `J. x 'c4. Liu e ocz -Ow netas.ins OWNER NAME, 8. ` # L9 ) , I�Iy^q� TENANT NAME(If Commercial): OWNER MAILING ADDRESS. /3 STREET . Lb 1140�'LJ CITY ..+r�y"' S�`A'(fr.:. M ZIP 2D OWNER PHONE: TOWNER EMAIL: CONTRACTOR NAME: J Y Q10 9 CONTRACTOR ADDRESS; STREET Lim woad CITY STATE ttn 48 20 CONTRACTOR PHONE:Li C:�d:C� 9 (10 CONTRACTOR EMAIL. C e lieaffyl } ilIan YY/ CONTRACTOR LIC.#(REQUIRED) O th G ) (6-flcM CITY OF EVERETT BUSINESS LIC.#(REQUIRE ) I Q PRIMARY CONTACT: 0 OWNERyCONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: Las a q a IQ CONTACT EMAIL: A. !a AGREEMENT.I hereby certify(hat have read end examined this application and know the same to be true and correct. All provisions of laws end 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 1 am 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 PERMIT# OwnortAuth rizad Agent Signature Date ( Revised 9/23/2016)