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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 /> U l l (CllYll/Y uo"I aj <br /> PROJECT ADDRESS <br /> III Zi��1 N ��� St- dY+?.l,itP ,►,�,� q�l' � ���-i��k-���r�t <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> G&S HEATING 3409 EVERETT AVE EVERETT, WA 98201 425-252-4402 <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> GSSHTGSH939RK 019685 <br /> State License Number(required) City of Everett Business 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: rbCcjm(+ <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 j <br /> I hereby certify that 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 PERMIT# <br /> violate or cancel the provisions of any other state or local law regulating construction or the �' _ n <br /> performance of construction. That/am authorized by the owner of this property to perform the /Vi(�uy <br /> work for which application is made and 1 comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC.J <br /> 0L <br /> Signature Date <br /> REVISED 08/06/2014 <br />