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Ju1.21.2016 8;42AM <br />N��, 33�7 F'. 2 <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EV�RETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98209 <br />425�257�BB10 � FAX 425�257-8857 — www.everettwa.org <br />�(�Z� � �� J � <br />PROJ�C7 ADDR�SS <br />Owner <br />Tenant <br />Mail Acldress <br />Mall Address <br />� <br />City <br />City <br />7.� �t«��r�� c���� <br />Stale/Zip Phone <br />Stale/Zip Phone <br />G&5 HEATING 3409 EVERETT AVE EVERETT, WA 9820'1 425-252-4402 <br />EleCtrlcal COntraCtor Mail Address City State/Zip Phone <br />GSSHTGSH939RK �19685 <br />State L.icense Num�er (required) City of Everelt Business License Number- (required) <br />RESIDENTIAL <br />Proposed Uso of I�uilding <br />Square Footage (If residential new construction, remodel or addition) <br />Number of devices (If low voltage) <br />Description of Work lo Be Done� �� <br />CITY OF �VERETT LOCAL SALES TAX CODE 15 3105 <br />Contract Price of Work <br />DAWN WEIMER 425-252-4402 <br />Contact personlContact Number/Email <br />1 hereby certify fh�f I have read and examined this applicaiion and know fhe same to be true and <br />Correct. AlI provisions of laws and o�linances goveminy tilis type of work wrll be completed <br />wheiher specified herein or nof. rhe granting of � permit doos nof presume fo give aufhority io <br />vio/ate or esnce/ the provisions of any otherstafe orlocallaw regulating consfruction or the <br />perfarrri�nCe of consfruction. Thst l am sufhorized by Ehe owner of thls prdperty io perform fhe <br />work for which application rs made and I comply with fhe State Contractors Law 18.27 RGW and <br />296.200 WAC. <br />"� I�1 I ��� <br />Signature Date ' <br />FEVlSED OB/08/20Y4 <br />FEE <br />�'�I � , �,c� <br />P�I�MIT# <br />E � r_ <br />�� i-I'�� <br />