10401 19TH PL W 2017-06-07 - Laserfiche WebLink

Mar. 29. 2017-10 : 14AM No. 5097 P. 1/4 ELECTRICAL PERMIT AI I ICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 93201 (P) 425-257-8810 1 FAX 425-257-8857 1 (E) everetteps@everettwa.gov 1 www.everettwa_gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: NO t L LLA—) BUILDING AREA(if residential, new construction, remodel, or addition) SF BUILDING TYPE: SFR-DETACHED ❑ SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: ❑ COMMERCIAL USE OF BUILDING: ELECT ICAI_ APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ o NUMBER OF DEVICES if low vol e : FIRE ALARM? ❑YES ❑ ASSOCIATED BUILDING PERMIT# if applicable): DESCRIPTION OF WORK: iJ1eC'�- ju" (� CONTACT INFORMATION OWNER NAME: ( TENANT NAME(If Commercial): OWNED MAILING ADDRESS: sTREET ' /�(y 1A, CITY ` STATE U— � 4 21F'(6 OWNER PHONE: -1-il- 0" OWNER EMAIL: CONTRACTOR NAME: G&S HEATING CONTRACTOR ADDRESS: STREET 3409 EVERETT AVE o,n EVERETT STATE WA Zip 98201 CONTRACTOR PHONE: 425-252-4402 1 CONTRACTOR EMAIL: DAWN @GSHEATING.COM CONTRACTOR LIC.#REQUIRED: GSHTGSH930RK CITY OF EVERETT BUSINESS LIC.#(REQUIRED: 019565 PRIMARY CONTACT: ❑OWNER 17 CONTRACTOR ❑ OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 425-252-4402 DAWN WEIMER CONTACT EMAIL: DAWN@GSHEATING.COM AGREEMENT,-i hereby certify that I have read and axominad this application and know the same to be true and conact. All provislons of laws and ordinances governing this type of work will t)e completed whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction. That i em authonzed by the owner of this property to perform the work for which application is made and I comply with the State Contractors Law 19.27 RCW and 296.200 WAC. City of Everett officiel Use Only r PERMIT# Owner/Authorized Agan Ignature r Date (Revised 9/23!2096)