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Feb, 7. 2017 8 : 13AM No, 4812 P, 2 <br /> � ELECTR�CAL PERMIT APPLICATION <br /> � C[71( OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EV�RETT, WA 9$20'I <br /> 425-257�8810 - FAX 425-257-8857—www.everettwa.org <br /> �..7,Y� � �.Pl�� \,J U�1. <br /> PROJECT ADDRESS <br /> ��� 4►� \1��o I�a ��,��1 �,� a��i���� q���C' <br /> dw�er � Mall Address City State/Zip Phone <br /> I��� �AJt�-L <br /> Tenant Mall Address City State/Zip Phone <br /> G&S HEATING 3409 EVERETf'AVE �VER�TT, WA 982p1 425-252-4402 <br /> Elec4rical Contraetor Mail Address Ciry State2lp Phone <br /> GSSNTGSH939RK 019685 <br /> State License Number(requireti) City of Everet#Business License Number(required) <br /> _� <br /> RESIDENTIAL <br /> Proposed Use of Fuilding Confract Price of Work <br /> DAWN WEIMER 425-252�402 <br /> Square Footage(If residential new construction, remodel or eddition) Contact Person/Contact Number/Email <br /> Number of devices(ff low voltage) <br /> Description of Work to Be Done: �1-�-�" C� ������ <br /> FEE <br /> C1TY OF EVERETT LOCAL SALES TAX COD�1S 3109 �� �_ <br /> I heraby certify that I have read and examined fhis application and know the same to be rrue and <br /> correct. A/l provisions of lsws and ordinances governing fhis type of work wi!/be completed <br /> whether specified herein ornot. The granting of a permit does nof presums fo give authority to PERMIT#' <br /> violate or cancel fhe provisions of any other sfate or local law regulating construcfion or tHe � ��O � Q <br /> performance of construction_ Thaf I am authoriied t�y the owner of this property to pertorm the - �2 � <br /> work for which applicah'on is made and I comply with the State Contracfors Law 18.27 RCW and <br /> 296.200 WA . <br /> _ �.��►I1� <br /> 5ignature Date <br /> REVISED 08/0�94 <br />