4813 ALPINE DR 2017-11-28 - Laserfiche WebLink

Sep, 12. 2017, 2, 04PM &CTRICAL PERMIT AP ICAi'1Ur`1 4� P " CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P) 425-257-8810 1 FAX 425-257-8857 1 (E) everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: A w ko-p. BUILDING AREA(if residential, new construction, remodel, or addition) SF BUILDING TYPE: SFR-DETACHED ❑ SFR-ATTACHED ❑ DUPLEX 1:1MULTI-FAMILY-#OF UNITS: 12 COMMERCIAL USE OF BUILDING: -i ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ NUMBER OF DEVICES if low voltage): FIRE ALARM? ❑YES NO ASSOCIATED BUILDING PERMIT# if a licable : DESCRIPTION OF WORK: CONTACT INFORMATION OWNER NAME: TENANT NAME If Commercial): OWNER MAILING ADDRESS: STREET �-'Ij v—L, CITY STATE Zip OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: G&S HEATING CONTRACTOR ADDRESS: STRPET 3409 EVERETT AVE cin EVERETT STATE WA zip 98201 CONTRACTOR PHONE: 425-252-4402 CONTRACTOR EMAIL: DAWN@GSHEATING.COM CONTRACTOR LIC.CREQUIRED : GSHTGSH930RK CITY OF EVERETT BUSINESS LIC.#(REQUIRED : 019865 PRIMARY CONTACT: ❑ OWNER O 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 exeminod this appllcatlon and know the same to be true and correct. All provisions of laws and ordlnwces governing this type of work MY be completed whether specified homin or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any otherstate or local law regtulating construction or the performance of oonstruction. That I am authon'zad by the owner of this property to perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only i csq owner/Authorizad Agent Signature Date (Rev/sad 9/23/2016)