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�CTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 � FAX 425-257-8857 � (E)everetteps@everetfinra.gov � www.everettwa.gov/permits <br /> � ���.� ? � �.; �� �. �.`�fi.�� � .__- � - � \ � '*�. y :: <br /> ros`£,���.. L�a Y.�f�i �.,.....,ggm, , ....._ _.::- <br /> � � � <br /> .��... ...an ro.... "_" .. ..__. _.. ab�w..- ... <br /> aT�,�.�� """""" " "..:" <br /> _ . ___ .sa....._._: .z. ...., v.w• v„ sa%. _., ��:., u.:5 .��aYY��.� <br /> PROJECT ADDRESS: ��O VY1 OI( I "U �Q� <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: � <br /> 'F_` - � ,.m�„-- � i6.r. mm�`1�� � � � 'g� �,'��" £_." p„�CS E3�. �' ,Y l��' �-�' <br /> �.������,�":". � \� ��F`� � t��2. m.�:i,�z�< � �..r,.•,� a ,�kz¢' `� "� <br /> CONTRACT PRICE OF WORK: $ <br /> NUMBER OF DEVICES if low voltage : <br /> FIRE ALARM? ❑YES .�/NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: 2GJ OI VL�� �O�.In �j , � G�,�(/V1,lr <br /> ��' ., r � ���� �; ���� \ ��; <br /> � ' ,,, �,,'���;, ��,,. �.;.. . �•�.�.. ..,.�... ,a�.�. .�.,���.��. .;.>�... � ��.. <br /> .,, �, <br /> � ,. <br /> OWNER NAME: TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: s-rReer ( (J �v <br /> �in. EVERETT STATE VV� ziP��Z�' �J <br /> OWNER PHONE: �Q O�(Q Z O �� OWNER EMAIL:N/A <br /> coNTRacTOR NAMe: IN HOUSE ELECTRICAL SERVICES, INC. <br /> coN-rRacTORa��Ress: STREET1530 117TH DR SE <br /> �,n LAKE STEVENS STATE WA Z,P 98258 <br /> CONTRACTOR PHONE:42rJ.7GO.3ZO3 coNTRacTOR eMa�: IHEPERMITS@GMAIL.COM <br /> coNTRacroR uc.#�REQuiREo>: INHOUES952QG CITY OF EVERETT BUSINESS LIC.#(REc2UiRED):044�6H <br /> PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: t�Z'rJ.76O.3ZO3 <br /> KELSEY coNTACT enna�:�HEPERMITS@GMAIL.COM <br /> AGREEMENT:I hereby certify that I 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 fo give authority to violate or cancel the provisions of any other state or <br /> loca/law regulating construcfion 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 Eve�ett O�cia/Use Only <br /> PERMIT# <br /> �2 z���� E l� c2 —�C� <br /> Owner/Auth rized Ag nt ignature Date (Revised 9/23/2016) <br />