Laserfiche WebLink
.." <br /> ELECTRICAL PERMIT APPLICATION <br /> '414 -4CITY OF EVERETT PERMIT SERVICES3200 CEDAR STREET,EVERETT,WA 98201 <br /> (F);425-257-8810 I FAX 425-257-8857 I(E)everetteps@evereftwa.gov{ www.evereftwagov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS; 1>66 CIV rA - t Kipr '1 q12 Ql <br /> IBUILDING AREA(if residential,new construction,remodel.or.addition) SF <br /> BUILDING TYPE: D:SFR-DETACHED SFR-ATTACHED 0 DUPLEX D MULTI-FAMILY-a.OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: 6-r I I V I V) <br /> ELE CAL APPLICATION INFORMATION <br /> OF <br /> CONTRACT PRICEW :$ '� "` <br /> NUMBER OF DEVICES(if lo voltage): <br /> FIRE ALARM? D YES Q <br /> ASSOCIATED BUILDING PERMITS(if applicable): <br /> DESCRIPTION OF WORK: wh01e ylome rf vviIre Giti(i dtY J \Scifv(GL <br /> 7-o at <br /> Ts <br /> ' .i• • i0 ft <br /> CONTACT INFORMATION <br /> OWNER NAME: Mfir e ut t [y 1 1M/tic p t i 4 TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: meet 10020 1/1(7'I /}f kW <br /> f�t�] <br /> CITY VC �^ .STATE �IIVA. z„, "t`fl I <br /> OWNER PHONE:411,,2'I.Oce Ira OWNEREMAL f <br /> CONTRACTOR NAME:In House Electrical Services, Inc. <br /> CONTRACTOR ADDRESS: STREET 1530117th DR SE. <br /> cirf Lake Stevens 87,,7E WA rfp 98203 <br /> CONTRACTOR PHONE:425-760-3203 1CONTRACTOR EMAIL: Ihepermits@gma,Lcom <br /> CONTRACTOR UC.1(Rt QtJRED): inhoues952gg acrly OF EVERETTBUSMESS LC.*REWIRED):044168 <br /> PRIMARY CONTACT: 0 OWNER 19 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 425-760-320 <br /> Kelsey CONTACT EMAIL:iheperalits@gmail.co <br /> AGREEMENP thereby cot*that I have read and examined thisnlicS. end know the SiSno to be hire and card.AO',rowboats of laws and O ISflCes governing this type <br /> ofworn wibecompleted whether specified herein et not. The graitlinviepem*does not pressing tow*author/tytoNat eorcancel the:proviskes:ofanyother a or <br /> local lawro Qonstructionart/le parkamincedoorutlueIlon. Thal aenauthorized bythe o allhismeetlytopertamlhewaekwt•tlichapplicationismudewtd:i <br /> comply with the State Ccsaiectois Law 1a27 ROW and WAC <br /> City of Everett Official Use Only <br /> 1 iiiik A '41/Ite/le) <br /> PERMIT <br /> E \log . l 3 <br /> Owned IP"'PPY"PrAgent r nate (Revisedw23fU16) <br /> Scanned with CamScanner <br />