921 51ST ST SW 2020-01-21 - Laserfiche WebLink

ELECTRICAL PERMIT APPLICATION !�► �. CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 I FAX 425-257-8857 I (E) everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 921 51ST ST SW Everett, WA 98203 BUILDING AREA(if residential, new construction, remodel,or addition) SF BUILDING TYPE: 0 SFR-DETACHED I SFR-ATTACHED 0 DUPLEX ❑ MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL USE OF BUILDING: Sf living ELECTRICAL APPLICA 4FORMATION CONTRACT PRICE OF WORK: $ $760 NUMBER OF DEVICES (if low voltage): FIRE ALARM? 0 YES El NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: (1) altered circuit for (1) outlet and hardwired fireplace CONTACT INFORMATION OWNER NAME:Terry Potter TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET 921 51ST ST SW cin EVERETT STATE WA ZIP 98203 OWNER PHONE: 425.879.1 123 OWNER EMAIL: N/A CONTRACTOR NAME: IN HOUSE ELECTRICAL SERVICES, INC. CONTRACTOR ADDRESS: STREET 1530 117TH DR SE cin. 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 0 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 PERMIT# ._ E �---1 C� c Owner/Authorized Agent Srgnaturej Date (Revised 9/23/2016)