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ELECTRICAL PERMIT APPLICATION <br /> e+�►�—r-' CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 ((E)everetteps©everettwa.gov..I www.everettwa.govtpermits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: - 02..0 d cit vv V - INS <br /> BUILDING AREA(if residential,new construction,remodel,or addition) SF <br /> BUILDING TYPE: D SFR-DETACHED ,SFR-ATTACHED CI DUPLEX 0 MULTI-FAMILY»#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: .0A,, <br /> ELE• .RICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF W• + $400 <br /> NUMBER OF DEVICES(if low voltage): <br /> FIRE ALARM? CI YE <br /> ASSOCIATED BUILDING PE IT#Of a. }° =We):DESCRIPTION OF WORK: D 0 O1Imp U►l 1MriTS r (2i V ,t/optW4e5 <br /> Ovid 4 d +s <br /> CONTACT INFORMATION <br /> OWNER NAME: "1 WV\ 2-0 tocArtS TENANT NAME Of Cotmmercial): <br /> OWNER MAILING ADDRESS: sower/04 Oar4-_k <br /> Grp f /pCQ1 STATE IA/Pr <br /> P 1Pfrb <br /> Deb <br /> OWNER PHONE:42 OWNER EMAIL: 113 <br /> CONTRACTOR NAME:In House Electrical Services,Inc. <br /> CONTRACTOR ADDRESS: sTREET 1530117th DR SE <br /> Ott,.Lake Stevens STATE,WA ZIP 98 <br /> CONTRACTOR PHONE:425-760-3203 (CONTRACTOR EMAIL: ihepermits@gmaiLCom <br /> CONTRACTOR UC.kREQUIRED):inhoues952qg [CIY OF EVERETTBUSINESS UC.#I;EQUIRED 044168' <br /> PRIMARY CONTACT: CI OWNER 10 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 425-760-3203 <br /> Kelsey CONTACT EMAIL:ihej,ermits@gmail.com <br /> AGREEMENT:I hereby certifyNutt i have mad and extunitled this emanation and know the semi to be true and comsat:M provisions of laws end Ofilinantlee governing this type <br /> of work will be canpletad whether speeted herein onot. The griaing.era peon/does not presume to give authority to violate or cancel the provisions of any other state or <br /> Axial law regulating construction or the perfonnence of construction. Tlpril atn authorized by the(*.nitro f thA property to perform the ins wit for which application is made and I <br /> comply with the State Comet is Law 18.27RCW and 296.200 WAC. <br /> CityofSwett OtroistUseOrly <br /> 41411 <br /> PERMIT <br /> 410A111 IOWA ° <br /> E -0(0 <br /> Own** ASH*,7"'"ra (Revised 9/23/201e) <br /> Scanned with CamScanner <br />