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0 0 <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 1 FAX 425-257-8857 1 (E) everetteps@everettwa.gov I www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: <br /> BUILDING AREA(if residential, new construction, remodel, or addition) SF <br /> BUILDING TYPE: ❑ SFR-DETACHED SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: ❑ COMMERCIAL <br /> USE OF BUILDING: �4 1A(Av, wln� <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK: $ l DW <br /> NUMBER OF DEVICES (if low voltage): <br /> FIRE ALARM? ❑YES `6 NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: W�l 3000IV LO V CAL I -L <br /> CONTACT INFORMATION <br /> OWNER NAME: 14 A- tUf �S(Q�'yl� y/ TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET �D 7/fJ�� >I v l/ Ln� <br /> ������ CITY r-1 / !i , / STATE /7 ZIP <br /> OWNER PHONE: 4�I= 425.Z31 � OWNER EMAIL: /v/A <br /> CONTRACTOR NAME: In House Electrical Services, Inc. <br /> CONTRACTOR ADDRESS: STREET 1530 117TH DR SE <br /> , Lake Stevens STATE WA ZIP 98258 <br /> CONTRACTOR PHONE: 425.760.3203 CONTRACTOR EMAIL: help@InhOUseelectrlc.Com <br /> CONTRACTOR LIC.#(REQUIRED): INHOUES952QG CITY OF EVERETT BUSINESS LIC.#(REQUIRED):044168 <br /> PRIMARY CONTACT: ®OWNER ❑CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 425.760.3203 <br /> Kelsey CONTACT EMAIL:kelseyreevesjc@gmail.com <br /> AGREEMENT:/hereby certify that/have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type <br /> 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 <br /> local law regulating construction or the performance of construction. That I am authorized by the owner of this property to perform the work for which application is made and I <br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> 4 / PERMIT# <br /> kl'­4A_'� -I EI'lo � - [� <br /> Owr�Wr/AulWiorized nt Sig ture Date (Revised 9/23/2016) <br /> I <br />