|
�LECTRICAL 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 /> �� �� �,,� �` � � :: �� � ,,
<br /> �';
<br /> �:.� ..� .:...:. . �... , , .
<br /> �...
<br /> . � , �
<br /> �. ,,, �....:.,. ...... ��,�..,.:....., � �...> . . :�..
<br /> PRo�ecTao�Ress: 2227 GRAND AVE EVERETT, WA 98201
<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 Bui��iNc: SF LVING SPACE
<br /> 7�� _� �� ,� ��
<br /> , .: >.,
<br /> L„" �•nu��c'�i�.� �`^ � - �c
<br /> � '. a..el;'31 :.>' F�:�:.... . y.;i>.�.9:"'.. � ...�': -_',�;,- ,� ,�.. ��.;{�� "'""":. .���
<br /> .,.,;�,.�. a, . , �a � � �m�
<br /> ,.w.«, '..... .,.,:. `-- .;-••��
<br /> . �.,...:�_.
<br /> CONTRACT PRICE OF WORK: $ 7500
<br /> NUMBER OF DEVICES if low voita e):
<br /> FIRE ALARM? ❑YES 0 NO
<br /> ASSOCIATED BUILDING PERMIT# if applicable):
<br /> DESCRIPTION OF WORK: Kitchen and laundry rewire - 70 amp subpanel and 6 circuits
<br /> �� � �c� s �� ;� ���'�' � "�� � �� � ���i� < i � '�.
<br /> �.�....a��� ....\�.,���'. :.., .Ti,.,..,v`�/i ,i , ,;:.:; _�u ��v . " �.. •- ° � �"� L i �'
<br /> �� � `
<br /> , A
<br /> .�� �:: ,,.,�i.?� ,..: .,-v:;� _, ...,..'. ......�.�'✓ ., u-.
<br /> OWNER NAME:COLLIN DILTZ TENANT�NAME(If Commercial):
<br /> OWNER MAILING ADDRESS: srReer 2227 GRAND AVE
<br /> �in. EVERETT STATE V V„ ZiP 98201
<br /> OWNER PHONE: 2OG.406.2707 OWNER EMAIL:
<br /> . .. ,.., . „
<br /> coNrRacrorx Nanne: IN HOUSE ELECTRICAL SERVICES, INC.
<br /> coNrwacroR a��Ress: STREET 1530 117TH DR SE
<br /> �,n LAKE STEVENS STATE WA Z,P 98258
<br /> CONTRACTOR PHONE: 4ZrJ.76O.3ZO3 coNTRacroR eMa�: IHEPERMITS@GMAIL.COM
<br /> coNTRacroR uc.#cREQuiReo>: �NHOUES952QG CITY OF EVERETT BUSINESS LIC.#(REQUIRE �:044168
<br /> ....... . ..... .. ..... ,..__ . .. .�.... .
<br /> PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR 0 OTHER(Please Specify)
<br /> CONTACT NAME: CONTACT PHONE: 4Z'rJ.76O.3ZO3
<br /> KELSEY coNracT enn,v�:�HEPERMITS@GMAIL.COM
<br /> AGREEMENT:!hereby certiry thaf l have read and examined this application and know the same to be true and correct. Al1 provisions of laws and ordinances governing this fype
<br /> of work wil/be comp/eted whether specified herein or not. The granting of a permit does not presume to give authorify to vio/ate or cancel the provisions of any other state or
<br /> 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 l
<br /> comply with fhe State Confractors Law 18.27 RCW and 296.200 WAC.
<br /> � /% t
<br /> �`� f �'' City of Everett O�cial Use Only
<br /> /
<br /> L. � ,, PERMIT#
<br /> ;' r2 . ��� I�- E l�-t 2 - t C�--(
<br /> Owner/�uthorized Agent Signa re Date (Revised 9/23/2016)
<br /> C
<br />
|