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Dec. 15. 2016 8: 19AM No. 4546 P. 1 <br /> • <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> • <br /> I1 S <br /> PROJECT ADDRESS <br /> Y�U�� ll - LCA .0 ( 17,$) <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mall Address City State/Zip Phone <br /> G&S HEATING 3409 EVERETT AVE EVERETT, WA 98201 425-252-4402 <br /> Electrical Contractor Mail Address City tate/Zip Phone <br /> GSSHTGSH939RK 019685 <br /> State License Number(required) City o Everett = siness License Number(required) <br /> RESIDENTIAL <br /> Proposed Use of Building Contract Price of Work <br /> DAWN WEIMER 425-252-4402 <br /> Square Footage(If residential new construction, remodel or addition) Contact Person/Contact Number/Email <br /> Number of devices (If low voltage) <br /> Description of Work to Be Done: _ 11\6a gYYV - <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certify that I 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 PERMIT# <br /> violate or cancel the provisions of any other state or local law regulating construction or the E Q <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 I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> 34ig to1, 111.110- <br /> ate <br /> REVISED 06/062014 <br />