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(4;iiiierr +LECTRICAL PERMIT A'LICATION
<br /> CITY OF EVERETT PERMIT SERVICES
<br /> 3200 CEDAR STREET, EVERETT, WA 98201
<br /> (P)425-257-8810 1 FAX 425-257-8857 1 (E)everetteps@everettwa.gov I www.everettwa.gov/permits
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<br /> PROJECT ADDRESS:62.02_ ,SecthVIv-s--- 4ve Fveve , (jA grbZQ�j
<br /> BUILDING AREA(if residential,new construction,remodel,or addition) SF
<br /> BUILDING TYPE: 0 SFR-DETACHED WFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL
<br /> USE OF BUILDING: A----P I A I/1 V11
<br /> CONTRACT PRICE OF WORK: $ 9)Y--
<br /> NUMBER OF DEVICES(if low voltage):
<br /> FIRE ALARM? 0 YES NO
<br /> ASSOCIATED BUILDING PERMIT#(if applicable):
<br /> DESCRIPTION OF WORK: R (II(��� d I h q c-Mr1(I re -from MO alwirs - TOO a wi O,S
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<br /> OWNER NAME: 2A1/I .91 rot VII dos TENANT NAME(If Commercial):
<br /> OWNER MAILING ADDRESS: STREET G)202 Secyk(l I5t A `'o
<br /> Cin. EVERETT STATE WA ZIP O 2_o 5
<br /> OWNER PHONE: OWNER EMAIL:N/A
<br /> CONTRACTOR NAME: IN HOUSE ELECTRICAL SERVICES, INC.
<br /> CONTRACTOR ADDRESS: STREET 1530 117TH DR SE
<br /> Cin.LAKE STEVENS STATE WA zip 98258
<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:l 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 /> 4`/ City of Everett Official Use Only
<br /> I, PERMIT#
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<br /> Owner/A horized Agent
<br /> Ore Date (Revised 9/23/2016)
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