Laserfiche WebLink
4[77- ECTRICAL PERMIT APP IC <br /> ATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P) 425-257-8810 1 FAX 425-257-8857 1 (E) everetteps@everettwa.gov I www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: f�-c t. (, S ti sr. <br /> BUILDING AREA(if residential,new construction, remodel, or addition) SF <br /> BUILDING TYPE: ®SFR-DETACHED ❑ SFR-ATTACHED 0 DUPLEX ❑ MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: 46,4,0;,/,„1--, <br /> 7� <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK: $ ^ >'a <br /> NUMBER OF DEVICES (if low voltage): <br /> FIRE ALARM? 0 YES 0 NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: ' P1&CZ 4<,, 1)./1(Vl 2-- <br /> J <br /> CONTACT INFORMATION <br /> OWNER NAME: , , <br /> �,'1--;✓.��; •(—�/( .¢{°C."-- TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET ? ( <br /> CITY !�',Lb:1 -F STATE GLZIP 2,k') <br /> OWNER PHONE: -jtr U-�Iei '-j & D.- OWNER EMAIL: <br /> CONTRACTOR NAME: G&S HEATING <br /> CONTRACTOR ADDRESS: STREET 3409 EVERETT AVE <br /> err), EVERETT STATE WA ZIP 98201 <br /> CONTRACTOR PHONE: 425-252-4402 CONTRACTOR EMAIL: DAWN@GSHEATING.COM <br /> CONTRACTOR LEC.#(REQUIRED): GSHTGSH93ORK CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 019685 <br /> PRIMARY CONTACT: 0 OWNER la CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 425-252-4402 <br /> DAWN WEIMER CONTACT EMAIL: DAWN@GSHEATING.COM <br /> AGREEMENT:I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type <br /> 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 <br /> local law regulating construction or the performance of construction. That I am authorized by the owner of this property to perform the work for which application is made and I <br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> q PERMIT# <br /> 1 1,,tk E Sot - c3 <br /> Owner/Authorized Agent Signature Dale (Revised 9/23/2016) <br />