6430 SYCAMORE PL 2018-02-23 - Laserfiche WebLink

Sep. 25, 2017� i ; 3�PM vo. 5867 P, 2 �ECTRICA�. I'ERM1T Af�LICA'1-IUN CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P) 425-257-8810 { FAX�25-257�8857 � (E) everetteps@everettwa.gov � www.everettwa.gov/permits PROJECT S1TE INFORMATION PROJECT ADDRESS' BUILDING AFt�A(if residential, new construcfion, remodel, or addi#ion) SF BUILDING TYPE: SFR-DETACHED ❑ SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNfTS� ❑ COMMERC]AL USE O�' BUILb[NG: �� ELECTRICAL APPLICATION INFORMA7'ION CONTRACT PRICE OF WORK: $ � NUMBER OF DEVICES if low volta e : --- — FIRE ALARM? ❑YES ,L�'NO ASSOCIATED BUILDING PERMIT� (if appllcable : DESCRfPTION OF WORK: � CONTpCT INFORMpT10N OWNER NAME: p(1�1L� TENANT NAME(if Commerclaf): OWNER MAILING ADDRE55: srReEr �,�,�j�� Y� L CI71' �' l/,� "�"3 STATE ZIP OWNER PHONE; OW[VER EMAtL: coNTw�cToR r�,ann�: G&S HEATING CONTRAC70R ADDRESS: sTReEr 3409 EVERETT AVE c,TM EVERETT �,,7E WA aiP 98201 CONTRACTOR PNONE: 425-252-4402 coNT�c-roR Enrt,a��: DAWN�a GSHEATING.COM coNT►�cTOR uc.#�R�Qu��u: GSHTGSH930RK CITY OF EVERETT BUSINESS LlC.#(REQUIRED): 019865 PRIMARY cONTACT: ❑OWNER � CONTRACTOR ❑ OTHER(Please Speeify) CONTACT NAME: CONTACT PHONE: 425�252�4402 DAWN WEIMER coNTACT EMA��: DAWN@GSHEATING.COM AGREEMENT. I hereby eartiFy that I navs read and er.am/ned this appllcaffon and know the same to be frue and comect. AI!provlsions of laws and ordinances govem/ng th/s typs of work w!!l bs compl�ted wheiher specifed herein or not. The grantrng of a perm;t dves not presume to give eufhvnty to vio/ate or cence/the provrsions of any other sfete ar locsl law regv/eting consfrucEron or the perfonrrance of constrvction. TRaf I am autlforrzad Dy tHa ownar of(h/s proparty to paitvrm tHa woNc for which applicafion is rr�aCe and I c❑mp�y with tne Stata Contractors Laev i8.27 RCW and 296.200 WAC. City of Everett O�clal Use Only PERMIT# ��.�1-� E c �� — Z L�--� OwnedAuthorized Agent Signature Data (Ravlsad 9/23/2016)