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45'77' ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 1 (E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> 4mm.�... ••. r.,..... I.•;...1 .a 3�V,:/ ... .. 3ncn._... 012.1)/b <br /> .. /.r... .. ��.. .. z�:__ i b' ,3.. ., �l.°x t... / <br /> PROJECT ADDRESS: 20 2_77 Mad Iso U ± \/ t(-e- , WA v 1"112.1)/b <br /> BUILDING AREA(if residential,new construction,remodel,or addition) SF <br /> BUILDING TYPE: 0 SFR-DETACHED -I 'SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: Sf 1 I VI <br /> .. Iia <br /> f <br /> ' �.�. ...--� . „�a•. � •. _�� �.:,_ .....ry .. �� ,..ti.� ^�r„��^.� .....�a..,tZU b;Zi,�- .�.,,,w <br /> CONTRACT PRICE OF WORK: $ 10/ 0 <br /> NUMBER OF DEVICES(if low voltage): <br /> FIRE ALARM? 0 YES 'ONO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): ++ <br /> DESCRIPTION OF WORK: pt 0 C A VV\ O` Inn & l am I/ f11/ A l v tl <br /> � <br /> ✓a,; ''''::IV <br /> ,4*,,, zP G .i171iAAT IINFOR I4` 041 f.. F *t '''*:;4 <br /> � 'n. <br /> OWNER NAME: TO in I/I C/9'v-t1 TENANT NAME(IfIfCommercial): - <br /> OWNER MAILING ADDRESS: STREET 2...0'7.--99 j�.A0d ;`f "Vl, S-1 /� <br /> CITY L�/ V V �/TE STATE VA ZIP 0 1 2_04-J <br /> OWNER PHONE: // OWNER EMAIL: �f <br /> u ,, ,,.,,,e tea•.... . .,.,,ate. ..,,, . . A"� ar <br /> CONTRACTOR NAME: In House Electrical Services, Inc. <br /> CONTRACTOR ADDRESS: STREET 1530 117th DR SE <br /> C1TY Lake Stevens STATE WA ZIP 98203 <br /> CONTRACTOR PHONE:425-760-3203 CONTRACTOR EMAIL: ihepermits@gmail.com <br /> CONTRACTOR LIC.#(REQUIRED): inhoues952qg CITY OF EVERETT BUSINESS LIC.#(REQUIRED):044168 <br /> PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 425-760-3203 <br /> Kelsey CONTACT EMAIL:ihepermits@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 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 /> A <br /> Ai R <br /> # <br /> Owner/Au orized A''Sigr re , Date (Revised 9/23/2016) <br />