2506 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 13R *Oz- , PROJECT ADDRESS, BUILDING AREA(IC residential,new construction,remodel,or addition) SF BUILDING TYPE: ;"SFR DETACHED 0 SFR-ATTACHED 0 DUPLEX ❑MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL .. USE OF BUILDING: .�..m...".••••w ^.... CONTRACT PRICE OF WORK: $ 2-SC7 00 NUMBER OF DEVICES IfIowvolta?e :: FIRE ALARM? 0 YES ►,�,:NO ASSOCIATED BUILDING PERMIT# ifa..It able' : TENANT � � . � • 0 3-.��. i OWNER'NAME: 0:,A ." 0 +} ai�masla OWNER MAILING ADDRESS: STREET / nA ® Cm, 'diel ' STATE W�.. _. ZIP drr ' it OWNER PHONE: c42 � OWNER EMAIL: CONT CONTRACTOR ADDRESS: .RAC'1'A' ADDRESS STREET ! . �e). r , cuy i STATE zm CiI CONTRACTOR PHONE � ' �� t �' CONTRACTOR EMAtL; �;.° .e CITY OF EVEREFT BUSIN 'LIC. (REQUJR ) 0 —1.-- PRIMARY CONTACT: 0 OWNER r CONTRACTOR 0 OTHER (Please Specify) CONTACT NAME: CONTACT PHONE: CONTACT-EMAIL *we : Ce AGREEMENT I hereby certify that have read and examined this application and know the same to be floe 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 stale or local law regulating construction or the performance of construction. That!am authorized by the owner of this property to perform the work for which application is made and! comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only PERMIT# Ownerokutttortted Agent signature 1�� Date (Revised 9/23/2016)