9027 9TH PL W 2018-01-16 - Laserfiche WebLink

E�ECTRICAL PERMIT A�ICATION ��1�j � 7�t�� CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P) 425-257-8810 � FAX 425-257-8857 � (E) everetteps@everettwa.gov � www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: ; '% ��? tJ� BUILDING AREA(if residential, new construction, remodel, or addition) SF BUILDING TYPE• SFR-DETACHED ❑ SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: ❑ COMMERCIAL USE OF BUILDING: 't� � �'�':r�;�� ;•_,� ELECTRICAL APPLICATION INFORMATION ,- CONTRACT PRICE OF WORK: $ `�� , ;1 i� NUMBER OF DEVICES (if low volta e): FIRE ALARM? ❑YES O ASSOCIATED BUILDING PERMIT# (if applicable): DESCRIPTION OF WORK: � 1,.�• •• �„ � �� CONTACT INFORMATION �r OWNER NAME: �-t'� ;��' �-4'�.� TENANT NAME(If Commercial): OWNER MAILING ADDRESS: sTREer �I i,� �'.N �� ,-� 't `'--�-/ CITY "� � �- �i.i� `. I � i�i° �.. !�� STATE ZIP OWNER PHONE: �II �'�-�'"- S ' OWNER EMAIL: CONTRACTOR NAME: G&S HEATING coNrRacroR ao�REss: STREET 3409 EVERETT AVE CITY EVERETT STATE WA ZIP 98201 CONTRACTOR PHONE: 425-252-4402 coNTRACTOR Ennai�: DAWN@GSHEATING.COM coNTR,acroR�ic.#�REQuiREo>: GSHTGSH930RK CITY OF EVERETT BUSINESS LIC.#(REQUIRED): O�9865 PRIMARY CONTACT: ❑ OWNER � CONTRACTOR ❑ OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 425-252-4402 DAWN WEIMER coNr,4cT EMa��: DAWN@GSHEATING.COM AGREEMENT:1 hereby cerfify that 1 have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be completed whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction. That I am authorized by the owner of this properfy 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 � � PERMIT# =/� I � I � ` �� E �� (� - �:��-c- Owner/Authorized Agent Signature Date (Revised 9/23/2016)