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12506 17TH AVE SE 2016-10-27
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12506 17TH AVE SE 2016-10-27
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Last modified
1/13/2017 3:11:54 AM
Creation date
10/17/2016 9:05:34 AM
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Address Document
Street Name
17TH AVE SE
Street Number
12506
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Jun, 21, 2016u 2;26PM � — No, 3127 P, 1 <br />_ , � � ��� ���� � - <br />ELECiRICAL P�RMIT APPLICATION <br />CITY OF EVERETT PERMMT S�F�VICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8610 - FAX 425-257-8857 — ww�+v.everettwa_org <br />i ����'1 �- �e S� <br />PROJECT ADDRESS <br />Owner <br />ienant <br />Malf Acldress <br />Mail Address <br />City <br />Cify <br />State/Zlp <br />Sfate/Zlp <br />� �3� �Q <br />phone <br />Phone <br />G&S H�A71NG 3409 EVERETT AV� EV�RETT, WA 98201 425-252-4402 <br />Elecfricai Gontractor Mail Address Cfly State/Zip Phone <br />GSSHTGSH939RK 019685 <br />Siate License Number (required) Ciiy of Everett eusiness License Number (required) <br />R�SID�NTIAL <br />Proposed Use of Building <br />5quare Footage (If resldentfaf new construction, remodel or additlon) <br />Number of cievices (If low voltage) <br />Description of Work to Be Done: <br />CITY OF EVERETT LOCAL SALES 7AX COQE IS 3105 <br />Contract Price of Work <br />DAWN WEIMER 425-252-4402 <br />Contact PersonlContact Number/Email <br />I hereby certify that I have read and �xamined thls applicafion and know the sarne to be�true and <br />correcf. Al! provlsions of laws �nd ordinances goveming th(s type of work wil/ be comp/afed <br />whether specified hereln or not. The granting of a permlt dves not presume to glve authoriEy fo <br />vlolate or cancel fh� provlsions o� �eny other sfate or local !aw regulating consfruC�lon or the <br />performance of construction. That I am aUfhorized by the owner of fhis properfy to perform the <br />work forwhlch appllcatlon is rr�ade and I comply wifh th� Sta�e Contr�ctors Law 18.27 RCW and <br />296200 WAC, <br />REVISED 08�6/201a <br />FEE <br />����°� <br />PERMIT# <br />E���`C�' ��� <br />
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