4424 FOREST DR 2017-06-12 - Laserfiche WebLink

May, 15, 2017 2: 18PM No. 5295 P. 1 ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES OL 3200 CEDAR STREET, EVERETT, WA 98201 (P) 425-257-8810 11=AX 425-257-8857 1 (E) everetteps@everettwa-gov I www.everettwa.gov/permits PROJECT'SITE INFORMATION PROJECT ADDRESS: I n C �J BUILDING AREA(if residential, new constfuctlon, remodel,or addltlon) SF BUILDING TYPE; SFR-DETACHED ❑SFR-ATTACHED ❑ DUPLEX ❑MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL USE OF BUILDING: h ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ NUMBER OF DEVICES if low voltage): FIRE ALARM? ES ❑NO ASSOCIATED BUILDING PERMIT# if applicable): DESCRIPTION OF WORK: ) CONTACT INFORMATION. OWNER NAME: TENANT NAME(If Commercial): OWNER MAILING ADDRESS: srREEr Cl'" STATE 21P OWNER PHONE:4OWNER EMAIL: ISQ z CONTRACTOR NAME: G&S HEATING CONTRACTOR ADDRESS: STREET 3409 EVERETT AVE ,,,, EVEFZr=7T STATE WA ZIP 98201 CONTRACTOR PHONE: 425-252-4402 CONTRACTOR EMAIL: DAWN@GSHEATING.COM CONTRACTOR LIC.#REQUIRED: GSHTGSH930RK ICITY OF EVERETT BUSINESS LIC.#(REQUIRED): 019865 PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 425-252-4402 DAWN WEIMER CONTACT EMAIL: DAWN@GSHEATING.COM AGREEMENT]hereby confly that I have read and examined this application and know the same to be true and correct. All provisions oflaws and ordinances governing this(ype of work will be Completed whether specified herein or not The granting of a permit does not presume to give authority to vlotalo or Cancel the provisions of any other state or local law regulating consfruction or fhe performance of constnictlon, That l am authorized by the owner of this properly to perform the work for which appllcatlon Is made and I comply with the State Contractors Law 79.27 RCW and 296.200 WAC. City oflrverett Official Use Only PERMIT# E i�5 r6� Own ertAut orized Agen a ure Date (Revised 9/23/2016)