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Sep, 20. 2016 3; 18PM <br />No.3800 P. 1 <br />ELECTRI.CAL. PERMIT APP�,ICATION <br />C1TY OF EVERETT PERIVI�7 SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8$57 � www.everettwa.org <br />���� L� ���� <br />�1Z1 ��,�-- � <br />PROJ�C7 ADDRESS <br />��U� ��1;,��.. � � l z�- � j c�.e.� <br />� p pp� c �r ,F'n rl � �— �I Z� ��.k� Y��� � (J�-OI`� ( `� ��� �' � —� 3��' <br />Owner Mqil Address City Stat�/Zip Phone <br />Tanant <br />Mail Address <br />C ity <br />State/Zip <br />Phone <br />G&S HEATING 34pg �VER�77 AVE EVERETT, WA 98201 425-252-4402 <br />Electrical Contr'aetor Mai[ Address Gity �� tate/Zip Rhone <br />GSSHTGSH939RK 019685 <br />State License Numb�r (required) Cify f Everett Bu ' ess License Number (required) <br />�—�� <br />RES[DENTIAL _ <br />Proposed Use of Building <br />quara Footage (If residential new construction, remodel or addition) <br />Number of devices (If low volfag�) <br />Contract Pnce of Work <br />DAWN WEIMER 425-252-4402 <br />Contact Person/Contact Number/Email <br />Description of Work to Be Done: `�� �� ����� <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />! hereby ce�tify t/7af I have read and eXsmined this applicafion and know the same to be true 8nd <br />correct. AI! provr"sions of/aws and ordinances govemirlg fhis type of work will be completed <br />whefher specified herein or not. The granting of a pBrmit does nof presume fo give authority to <br />vrolate orcence! the prov�sio»S of any other sfate orlocallaw regulating constructror] or fhe <br />per'farrnance ,of construction. That I�m authorized by the owner of this property fo perform the <br />work fOr which spplication is made and l comply with the Stafe Contracfors Law 98.27 RCW and <br />296.Z00 WAC. <br />n atu re <br />REVfS6o a�o9/2otia <br />��I�I1� <br />Date <br />FEE <br />PERMIT# <br />E � G�G�—C �� <br />