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Jul. 21, 2017_ 2 . 57PM IVo, 5588 P. 1 <br /> OLECTRICAL PERMIT AFOLICA-1 1V N <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 95201 <br /> (P) 425-257-8810 1 FAX 425-257-8857 J (E) everetteps@everettwa.gov 1 www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: \(;'� 0 _F'o <br /> BUILDING AREA(if residential, new construction, remodel, or addition) SF <br /> BUILDING TYPE: L1"5FR-DETACHED ❑ SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: ❑ COMMERCIAL <br /> USE OF BUILDING: Cad a-� <br /> /k*E—CTNCAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK: $ 1 c) <br /> NUMBER OF DEVICES if low volta ): <br /> FIRE ALARM? ❑YES <br /> ASSOCIATED BUILDING PERMIT# If a licable : <br /> DESCRIPTION OF WORK: <br /> CONTACT INFORMATION <br /> OWNER NAME: "� \�- 'r Ck-k ) TENANT NAME(If Commerclal): <br /> OWNER MAILING ADDRESS: STREFT �\ <br /> CITY ) -, �i j; STATE ZIP <br /> OWNER PHONE: - ,;:�:;',— -� 1OWNER EMAIL: <br /> CONTRACTOR NAME: G&S HEATING <br /> CONTRACTOR ADDRESS: sTR66T 3409 EVERETT AVE <br /> c,Tv EVERETT STATE WA ziP 98201 <br /> CONTRACTOR PHONE: 425-252-4402 ICONTRACTOR EMAIL: DAWN @GSHEATING-COM <br /> CONTRACTOR LIC.#(REQUIRED): GSHTGSH930RK ICITY OF EVERETT BUSINESS LIC.#(REQUIRED)//P19865 <br /> PRIMARY CONTACT: ❑ OWNER 17 CONTRACTOR ❑ OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE. 425-252-4402 <br /> DAWN WEIMER CONTACT EMAIL: DAWN@GSHEATING.COM <br /> AGREEMENT.'1 hereby cert/(/that I have reed and examined this application and know the same to be true and correct. All provisions of laws and ordlnances governing this type <br /> of work will be completed whether specified harain or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other etete or <br /> local law regulating construction or the panbrmance of construction. That!em authorized by the owner of this property to perform the work for which application is made and 1 <br /> comply with the State Contractors Law 1a,27 RCW and 296.200 WAC. <br /> Clty of Everett Official Use Only <br /> PERMIT# <br /> -11-?A �;� E lqC54 - �S Ll <br /> Owner/Authorized Agent Signature Date (Revised 9/23/201 e) <br />