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Ap r. 1. 2016 12: 59PM No, 2451 P. 1 <br />.-- ---. <br />� � <br />EL.ECTRICAL PERMIT APPLICATIQN <br />CfTY OF EV��2ETT PERMIT S�RV�CES <br />3200 CEDAR STk�E�T, EVERETT, WA 98201 <br />42�-257-8810 - FAX �425-2�7-8857 — www.ever�ttwa.org <br />�,Y� ^'� � ���,� 1,�' ' f f2.,..� <br />.,� � • �'..:,,� <br />PROJECT ADDRLSS <br />Ownor <br />Teitiarit <br />F� �` :� �.. J� ,. <br />���.. <� ) .�(� �- :�:. �';7�,, <br />Mall Addross � � <br />Mai! Address <br />Clty <br />ClIY <br />StHte%'%Ip <br />Sfate/Zip <br />. ,� <br />Phone <br />Phone <br />G&S HEATING 3409 �VERETTAV� �VERETT, WA98201 425-252-4�1�2 <br />--._,,, _....,.- - ....:. _.,.,,... <br />EIeC(i�ICAI Contracto� M�il Address City State/Zip Phone <br />GSSH7GSH939RK 019685 <br />Stafe License Ninnber (rec�uired) City of tverett Business License Numbcr (requlred) <br />R�SIDENTIAL <br />Pr�pased Use of [iuilding <br />Syuare Foofago (If residentlal new construciion, rcmodel or adcEifion) <br />Number of devices (If Iow vofiagc) <br />Contract Price of WoI'k <br />�AWN WElMER 425-252-4ao2 <br />nfacf F'erso�z/Contact Numbor/Emai€ <br />��,, I ) <br />Descri}�tion of Work t� Be Dor�e: ��� ��� ,.,. � l/� {�..� � cs�( '�1��f1v'�� �'�..�����' <br />FEE .._. <br />CITY OP EVERETT LOClaI. SALES TAX CODE IS 3105 (I'��!-` �� <br />I irereby ceitify that 1 h��vc: reHd ar�d examinoc! this apFrlic»!!a� a�>d know the sarnc tr� br; frue and ��X '/�' <br />corrcct. AI! pr�visrons of laws ar7d orrli>>ances goveminc� this typc vf work will be completod <br />whetl�erspocifrccl hr:rein ornoi. The �raniing of,� p�rrr�il does notpl�osu�nc ta yive auflio�ity to PERMIT# <br />violrj(e cii cance! the provisions a! er�y other state or local J��w r�yulafinc� ca�str7rction or fht: r <br />�erformancr, ol r.�o�islruotion. That I an� yuli�ory�ed by the owr�or af this F7rr}perfy to ��erfonz� tlto �, ��� �"� l� <br />wor!< (or which applicafiorr is mAcle ancl I canply wifl� Ihe Slate Confractors Law 98.27 RCW and � <br />29fi.200 WlIC. _ <br />� �°.�f <br />Da <br />REVI:;EU U8/OP,/�p fJ <br />� <br />