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Dec, 22. 2016 7 . 20AM No, 4598 P. 1 <br /> • <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> PROJECT ADDRESS <br /> lz�U.Vl 2, 10013 Ir v e� fl ►� tt�la :�S-7j--1 '21)(0--`f S-`(� <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mall Address City State/ZIP Phone <br /> G&S HEATING 3409 EVERETT AVE EVERETT, WA 98201 425-252-4402 <br /> Electrical Contractor Mall Address city State/Zip Phone <br /> GSSHTGSH939RK 019685 <br /> State License Number(required) City of Everett Business License Number(required) <br /> RESIDENTIAL <br /> Proposed Use of Building Contract Price of Work <br /> DAWN WEIMER 425-252-4402 <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: I)U tA,3 —� <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <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 goveming 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 , <br /> performance of construction. That/am authorized by the owner of this property to perform the <br /> work for whic application is made and i comply with the State Contractors Law 16.27 RCW and <br /> 296.200 <br /> fzlu f Ic� <br /> Signature Date <br /> REVISED 0MCY20N <br />