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Ma r. 2, 2017 7 ; 24AM No. 4959 P. 1 <br /> _ � , <br /> ELECTRICAL PE�MIT APPLICATIO[V <br /> CITY OF EVERETT PERMIT SERVlCES <br /> 3200 CEDAR STR��T, EVER�TT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www_everettwa.org <br /> '1�tc�t '1'�`��� <br /> PROJECT ADDRESS <br /> \ �r� �uxc�1� �1�tou ��-^ b�� �.v�,�,i�,v-�PC �Go� �2�=�s3-�a�t� <br /> Owner Mail Address Clty 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 /> Elecfrical ContrBCtor Mail Address City State/Zip Phone <br /> GSSHTGSH939RK 019685 <br /> State License Number(required) City of Everett Btasiness�icensa Number(required) <br /> RESIDENTIAL �� <br /> Proposed Use of Building Contract Price of Work <br /> DAWN WElMER 425-252-4402 <br /> Square Footage(If residential new construction, remodef or addition) Contact Person/Contact Number/Emaif <br /> Number of devices (If low voltage) <br /> Description of Work to Be Done: �I S( 1��� S V�. �'�� �% ���5� <br /> �"� � , <br /> . � <br /> FEE <br /> CITY OF EV�R�TT LOCAL SALES TAX CODE 15 3105 <br /> !hereby certify thsf i have read and exemined fhis application and know fhe same to be true and <br /> correcf. A!I provis�ons Of lawS and ordinances goveming this type of worfc will be complefed <br /> whether specified herein or no�. The granting of a permit does not presume to give aufho�fy fo PERMIT# <br /> v�ol&fe or car7cel the provisions of any other state or/ocal law regulating construcfion or fhe � � � /� � ^ <br /> performance of CORstructio�. That/am authonzed by the owner of this property to perform fhe V j '�' ��� <br /> work for which applicafion is mada and 1 comp/y with the SfBte ContrBctorS Law 18.27 RCW and <br /> 296.200 WAC. <br /> _ gz 11 <br /> Sig ature Date <br /> REVlSED 09/b6l1014 <br />