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4m- __ECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 1 FAX 425-257-8857 1 (E) everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE, / INFORMATION PROJECT ADDRESS: I"i//��0 1 lQ±/1 �j VPiV 1 v�J ()Ica 2U I BUILDING AREA(if residential, new construction, remodel, or addition) SF BUILDING TYPE: ❑ SFR-DETACHED 'SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL USE OF BUILDING: 2 II V 1 I�G"� )ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ X000 NUMBER OF DEVICES (if low voltage): FIRE ALARM? ❑YES ' NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: 2{�( C }'tcr 61/161 mat CONTACT INFORMATION OWNER NAME: Iz---0t YI M (j L 0100 I/1 l I Vi TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET I U V k I� c,T, EVERETT STATE WA ZIP 2 ZO) OWNER PHONE: �L. V • I-/ 2 . 12471 OWNER EMAIL: N/A CONTRACTOR NAME: IN HOUSE ELECTRICAL SERVICES, INC. CONTRACTOR ADDRESS: STREET 1530 117TH DR SE CITY LAKE STEVENS STATE WA ZIP 98258 CONTRACTOR PHONE: 425.760.3203 CONTRACTOR EMAIL: IHEPERMITS@GMAIL.COM CONTRACTOR LIC.#(REQUIRED): INHOUES952QG CITY OF EVERETT BUSINESS LIC.#(REQUIRED):044168 PRIMARY CONTACT: 0 OWNER la CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 425.760.3203 KELSEY CONTACT EMAIL:IHEPERMITS@GMAIL.COM 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 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 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 comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only 11) PERMIT# �//0 E 1, (60 ( r 2C-1 Owner/Authorized Agent Sigure Date (Revised 9/23/2016)