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477 ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 ( FAX 425-257-8857 ( (E) everetteps@everettwa.gov I www.everettwa.gov/permits <br /> ECTS ITE1NFORMATI ON <br /> PROJECT ADDRESS: P j, e :i -Li e <br /> BUILDING AREA(if residential, new construction,remodel, or addition) c9 1 C SF <br /> BUILDING TYPE: TZSFR-DETACHED 0 SFR-ATTACHED ❑ DUPLEX 0 MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL <br /> F <br /> USE OF BUILDING: j -° S o d <br /> ':'ELECTRICAL:' PPLICA : N°: <br /> CONTRACT PRICE OF WORK: $ Lf 4.I b <br /> NUMBER OF DEVICES(if low voltage): <br /> FIRE ALARM? 0 YES 0 NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: ,. 7(')() 4,-,\ s', th6A,--- r;(-1 [,y; 1,' y r <br /> OWNER NAME: 7-rt Ch (i' r l C+,,A,SLA TENANT NAME� (If Commercial): <br /> OWNER MAILING ADDRESS: STREET 72<-, j) C )(� <br /> CITY T STATE I, j CA ZIP <br /> OWNER PHONE: 11P "-C �J_`�4"75 OWNER EMAIL: la C-4€!J C': tnrti z t - ( 9 iroall,: L• CO re's <br /> CONTRACTOR NAME: G&S HEATING <br /> CONTRACTOR ADDRESS: STREET 3409 EVERETT AVE <br /> CITY EVERETT _ STATE WA ZIP 98201 <br /> CONTRACTOR PHONE: 425-252-4402 CONTRACTOR EMAIL: DAWN@GSHEATING.COM <br /> CONTRACTOR LIC.#(REQUIRED): GSHTGSH93ORK CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 019685 <br /> PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 425-252-4402 <br /> DAWN WEIMER CONTACT EMAIL: DAWN@GSHEATING.COM <br /> AGREEMENT:I hereby certify that I have reed 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 /> City of Everett Official Use Only <br /> r <br /> sic <br /> P <br /> / ti PERMIT# <br /> 0 _ , ElVc3LO1Co <br /> Owner/Authorized Agent Signature Date (Revised 9/23/2016) <br />