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Sep, 14. 2016 8 : 48AM No. 3766 P. 1 <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-2578810 - FAX 425-257-8857—www.everettwa.org <br /> ky E <br /> PROJECT ADDRESS <br /> ZD <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 Mall Address city Stateizlp Phone <br /> GSSHTGSH939RK D19685 _ <br /> State License Number(required) City of Everett <br /> "Business License Number(required) <br /> RESIDENTIAL $ <br /> Proposed Use of Building Contract Price of Work <br /> j�)o0 5F DAWN WEIMER 425-252-4402 <br /> Square Footage(If residential new construction, remodel or addition) Contact Person/Contact NumberiEmail <br /> Number of devices(If low voltage) <br /> Description of Work to Be Done- bf— Or E�I IK (::Al rU K—fV <br /> FEE <br /> CITY OF EVERETT LOCAL SALT-S TAX CODE IS 3105 �(;l <br /> i <br /> I hereby certify that I have read and examined this application and know the same to be true and <br /> correct. Ali 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 r <br /> performance of construction. That I am authorized by the owner of this property to perform the t <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and v <br /> 296.200 WAC. <br /> Signature Date <br /> ,REVISZD 0W&W10 <br />