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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,.EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 428.287-8857 1(E)everettepsaeverettwa.govi www.everettwaVoY/Perrnits <br /> w „#. „ . 4; 4 �Itaitr O TIiOtt P a :s i n <br /> PROJECT ADDRESS:4017 Grand AVE Everett WA 98201 <br /> BUILDING AREA(if residential,new construction,remo0e1oraddition) SF <br /> BUILDING TYPE: 0 SFR-DETACHED I SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY #OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: sf living <br /> CONTRACT PRICE OF WORK:$ <br /> NUMBER OF DEVICES(if low voltage): <br /> FIRE ALARM? CI YES O.NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: alter 15 amp circuit for new light in kitchen <br /> ��. 4_ ,, ...` 0.14fACf”INFO ATION ,,,,' <br /> OWNER NAME:Kate Kessler - TENANT NAME(0 Commercial) <br /> OWNER.MAILING.ADDRESS: smear 4017 Grand Ave <br /> „.Everett STAT WA zr+98201 <br /> OWNER PHONE; na OWNER EMAIL:na <br /> CONTRACTOR NAME:in House Electrical Services, Inc, <br /> CONTRACTOR ADDRESS: aTeaer 130117th DR SE <br /> W <br /> an LkStevens , WA zip 98258 <br /> CONTRACTOR PHONE:428760323' CONTRACTOR EMAIL:iheperfrlits©gmail.cOm- <br /> CONTRACTOR LJc. t2EQUI — <br /> RED•: inhoues9524g-nCITY OF EVEserr BUSINESS UC.#(REQuIRED):044168 <br /> PRIMARY CONTACT: D OWNER la CONTRACTOR a OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 4257603203 <br /> Kelsey`' CONTACT EMAIL:ih ermitS@gmaii.comi <br /> AGREEMENT:I hereby certify nett have ill and exami ed this eppketion and lnowTesate lobe hve and totted..A111Nevietons oi` ra scud ntlearece$goverethe this iy'pe <br /> of warlcwr be c eted whether Sper dherein erect. The r.ofa 8 d e nctpresumetogive autHod. to violate ores:we,the.prt &a1•anyeserstate or <br /> Com rre 4ahng... " •,• :crthe•:; _ ..n., ..r .r That . r._.#tyghs,ownerofthis <br /> PropertY "durmthew®ricfort►dlkcel lsr teand) <br /> cprrllfly N'ftH ttre .••• 7827 Wand .�,..ts R <br /> ✓� <br /> CIty of Everett•Official Use t7My' <br /> �` a— <br /> IsERMIT# <br /> Alip <br /> A& E 18 /040 <br /> Owned . prized Agent 8i1atttre Date. (Revised 9/23/2016) <br /> Scanned with CamScanner <br />