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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 /> lop'aI 3rd Dr SF <br /> PROJECT ADDRESS <br /> ur (_ busrnr. 10m, pyj [fir sE-. EvTMji: W8 cr axq <br /> Owner Mail Address City State/Zip Phone <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 503.M <br /> Proposed Use of Building Contract Price of Work <br /> a;k aLl:� 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: �� <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 J <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 ' �w <br /> performance of construction. That I am authorized by the owner of this property to perform the .,.. J` <br /> work for which application is made and 1 comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> Signat re Date <br /> REVISED 08/06/2014 <br />