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Jun, 30, 2016 1 : 32PM No. 3204 P. 1 <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 /> PROJECT ADDRESS <br /> i <br /> OwnerAA Mail Address City Stato2lp Phone <br /> IvII/fA <br /> Tanant Mail Address City State/Zip Phone <br /> G&S HEATING 3409 EVERETT AVE EVERETT, WA 98201 425-252-4402 <br /> Electrical Contractor M211 Address City State/Zip Phone <br /> GSSHTGSH939RK 019685 <br /> State License Number(required) Clty of Everett Business License Number(required) <br /> RESIDENTIAL 2-H W - ego <br /> Proposed Use of Building Contract Price of Work <br /> n¢, DAWN WEIMER 425-252-4402 <br /> Square Footage(If residential new construction, remodel or addition) Contact Person/Contact Number/Email <br /> Y <br /> Number of devices(If low voltage) <br /> Description of Work to Be Done: I IQ c511 LU N�V J AOR' "0,)Q IJ 3PLCRKL� <br /> Lpa,3 <br /> FEE <br /> CITY or EVERETT LOCAL.SALES TAX CODE IS 3106 U 'bd <br /> 1 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 presuma to give authority to PERMIT# <br /> violate or cancel the provisions of any other state or local law regulating construction or the <br /> performance of construction, That.I am authorized by the owner of this property to perform the <br /> work for which application Tmd I comply with the State Contractors Law 18.27 RCW and <br /> 296.200W <br /> AC. I� <br /> gnaiure pate <br /> REVISED aarosr019 <br />