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Jun, 20, 2017- 1 : 09PM 0 No, 5472—P. 2 <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425257-8857 -www.everettwa.org <br /> i aa,') n'l a Iy- <br /> PROJECT ADDRESS <br /> �Y1r�n. Df)n 0;.1 V I LqN1�' <br /> Owner Mail Addr§Sj City State/Zip Phone <br /> '5( a S <br /> Tenant Mail Address City State/Zip Phone^ <br /> G&S HEATING 3409 EVERETT AVE EVERETT, WA 98201 425-252-4402 <br /> Electrical Contractor Mail Address city State/Zip Phone <br /> GSSHTGSH939RK 019685 <br /> State License Number(required) City of Everett Business License Number(required) <br /> RESIDENTIAL 1a).(J <br /> Proposed Use of Building Contract Price of Work <br /> I�a� DAWN WEIMER 425-2524402 <br /> Square Footage (If residential new construction, remodel or addition) Contact Person/Contact Number/Email <br /> Number of devices (If low voltage) <br /> Description of Work to Be Done; r V I C f <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE 13 3105 60 <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 presume to give authority to PERMIT# <br /> violate or cancel the provisions of any other State or local law regulating construction or the I� 1 <br /> performance of construction. That I am authorized by the owner of this property to perform the <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> 4 'p � <br /> Signature Date <br /> REVISED OW 612014 <br />