1334 LOMBARD AVE 2019-02-11 - 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.gov/permits SiORtS1 : PROJECT ADDRESS: I ' azt_ BUILDING AREA If residential,new construction,remodel or addition)) SF BUILDING TYPE: %SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL use OF BUILDING: CONTRACT PRICE OF WORK: $ ,pO NUMBER OF DEVICES if low volta!e FIRE ALARM? 0 YES 0 NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: efX,S. K %Lt., t; 4101014 OWNER NAME , TENANT NAME2%Commetclttl)t OWNER MAILING ADDRESS: STREETI V STATE ZIP gg.Gi-/ OWNER.PHONE: • , :rig OWNER EMAIL: CONTRACTOR NAME. Crrt CONTRACTOR ADDRESS; STREET 1415 Woctli• STATE WA' ZIP qt 20 1 CONTRACTOR PHONE. 1.1a5 ' q CONTRACTOR EMAIL: CONTRACTOR LIC. REQUIRED , } l d�, CITY OF EVERETT BUSINESS LIC,#(REQUIRE0) t1 PRIMARY CONTACT: 0 OWNER .,,CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: `�� X59 ado CONTACT EMAIL, 0,, to •COIN AGREEMENT:I hereby certify that have read and exam/ned this application and know the same to be free 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 slate or local law regulating construction or the performance of construct/on. That I am authorized by(he 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# .._ )24 12. 4.1 Owner/Aust•ttzed Agent Signattn Data (Revised 9/23/266)