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#0111* ELECTRICAL. PERMIT APIIUCATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA•98201 <br /> (P)425-257-8810 I FAX 425-257-8857 I(E)everellepstileverettwa,gov I www.everettwagov/permits <br /> PROJEcT ADDRESS:2406Hillside LN Everett, WA 98203 <br /> BUILDING AREA(if residential,new construction,remodel,or addition) SF <br /> BUILDING TYPE: 0.SFR-DETACHED fa SFR-ATTACHED 13 DUPLEX Ci MULTI-FAMILY-it OF UNITS: CI COMMERCIAL <br /> USE OF BUILDING: Sf living <br /> - ,.. <br /> . k.,..:''''::vONFSIMPO..*;‘141SikiNel <br /> CONTRACT PRICE OF WORK:$ 800 <br /> NUMBER OF DEVICES(if low voltage): <br /> FIRE ALARM? 0 YES la NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: 15 amp altered circuit fr new switch <br /> OWNER NAME:Nick Pembroke TENANT NAME(If Commercial): <br /> OWNER MAILING MAJUNG ADDRESS: STREET 2406 Hillside LN <br /> %at a <br /> an,Everett STATE WA Zp 98203 <br /> OWNER PHONE: na OWNER EMAIL:na <br /> , <br /> CONTRACTOR NAME: In House Electrical Services, Inc. <br /> CONTRACTOR ADDRESS: wreEz1530 117th DR SE <br /> ony Lake stevenes STATE VVA zp 98258 <br /> CONTRACTOR PHONE:4257603203 'CONTRACTOR EMAIL:ihepermits©gmailcom <br /> CONTRACTOR LIC. ' REQUIRED inhspues952qg CITY OF EVERETT BUSINESS LIC.*REQUIRED):044168 <br /> , ... <br /> PRIMARY CONTACT: CI OWNER RI CONTRACTOR C3 OTHER(Please Specify) , <br /> CONTACT NAME: CONTACT PHONE: 4257603203 <br /> , <br /> kelsey CONTACT Ewduitieperrnitsegrnail.com <br /> AGREEmENr,thereby certif ythat,I haw read and exernined this appkation and knoWthe same to belay and correct. All provisiorer alarm end ordinances governing this type <br /> of d,wio be oompieted whether specried hen*sy wt. The prantire;0 f a pennedoes not preemie to give authority to violate or can the provisions of any other state or <br /> local law regulating construction or thaperformance of censIni- lam euthelized by the owner et this Mee*te Pelle=The wore for which application Is made and I <br /> Comply with the State Contractors Law 18.27 RCW and -,!i.200 WAC. <br /> /° 2' <br /> * <br /> City of Everett Official Use Only <br /> PERMIT# <br /> Vic . tO - 2l (0 <br /> O•wneriAuthortzed Agent Signature Date ' (ROvIsed 9/2312010 <br /> - • <br /> Scanned with CamScanner <br />