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ELECTRICAL PERMIT APPLICATI�N <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - F�X 42 257- 857 — www.everettwa.orgI" <br />��, �,r� � , �.l;��, ��(1�-��M�-- V)t,� �Z�ii/l.(,�YVL�� <br />.r_ L J <br />�� �� �� � ���� <br />�I � U 1 �� � ��-h" u`�'`�-� <br />PROJECT ADDRESS <br />-� �-�" '�� (,Lt"z, �(�( ►1 � ���t'�� ,�"�h.� �'j `�Z�� �-t�' � - �-i � � -�S �z-j � <br />Owner Mail Address City State/Zip Phone <br />Tenant <br />Mail Address <br />G&S HEATING 3409 EVERETT AVE <br />Electrical Contractor Mail Address <br />GSSHTGSH939RK <br />State License Number (required) <br />RESIDENTIAL <br />Proposed Use of Building <br />City <br />EVERETT, WA 98201 <br />City <br />Square Footage (If residential new construction, remodel or addition) <br />Number of devices (If low voltage) <br />Description of Work to Be Done: <br />U (� <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />State/Zip <br />425-252-4402 <br />State/Zip <br />Phone <br />Phone <br />019685 <br />City of Everett Business License Number (required) <br />Contract Price of Work <br />DAWN WEIMER 425-252-4402 <br />Contact Person/Contact Number/Email <br />�1,('V��t L.�� <br />1 hereby certify fhat 1 have read and examined this application and know the same to be true and <br />correct. All provisions of laws and ordinances governing this type of work will be completed <br />whether specified herein or not. The granting of a permit does not presume to give authority to <br />violate or cancel the provisions of any other state or local law regulating construction or the <br />performance of construction. That I am authorized by the owner of this property to perform the <br />work for which application is made and 1 comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />� I� � I�� <br />ature <br />REVISED 08/O6/2014 <br />uate <br />FEE <br />..� � � <br />PERMIT# <br />E G�O�-D`-�� <br />