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Ap r, 26. 2017_ 1 : 08PM No, 5223 P. 2 <br /> �LECTRICAL PER�VIIT" �PLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERE77, WA 98201 <br /> (P)425-257-8810 � FAX 425-257-8857 J (E] everetteps@ever�ttwa.gov � www.e�erettwa-gov/permits <br /> , � PROJECT S�T� �N�ORMATION <br /> PRQJ�CT ADDRESS: ��� ` �'-� S � <br /> BUILDING AREA(if res9 ential,new cvnstruction, remodel,Qr addition) SF <br /> BU[LDING TYP�: SFR�DE7ACHED ❑SFR-ATTACHED ❑ DllPLEX � MULTI-FAMILY-#OF UNfTS: ❑ COMMERC[AL <br /> USE O�BUILDING: r \ � �, � � <br /> ELECTRICAL APPL�CATION INFORMATION <br /> CONTRACT PRICE OP WORK:$ j (�.QQ <br /> NUMBER OF DEVICES if low volta e : <br /> FIRE ALARM? ❑Y�S ❑NO <br /> ASSOCIAT�D BUILDING PERMIT# if applicable : <br /> D�SeRi�TioN OF WORK: 1 ��'Y1S�C�r \� �L � <br /> CONTACT INFORMATION <br /> OwNER NAM�: TENANT NAME(ff Commercial : <br /> OWNER MAILINC ADDRESS: 1 STREET � � '� • <br /> CIT� � STATE, ZIP�� � <br /> OWNER PHONE: — 7 p�4`-� OWN�R EMAIL: <br /> CONTRACTOR NAME: G&S HEATING � <br /> CONTRACTOR ADDRESS: sTRe�34p9 EV�I�ETT AVE <br /> cin EVERETT STATE �vA z�P 9$201 <br /> CONTRACTOR PHON�; 425-252-4402 CONTRACTOR EMAI�: DAWN@GSHEATING.COM <br /> CONTRACTOR LIC,#REQUIRED): GSHTGSH930RK CI7Y OF EVERETT BUSINESS LIC,#tREQv�R��: 019865 <br /> PRIMARY CONTACT� ❑OWNER f�J CONTRACTOR ❑ OTHER(Please Specify) <br /> CONTACT NAM�: CONTACT PHONE: 425-252-4402 <br /> DAWN WEIMER coNrACT EMaI�: DAWN a�GSHEATING.COM <br /> AGREEMENT.•!nareby certHy that�have read and exam;ned tnis epplicatlen and know the same to pe tn�e and cor�ect. All provisions oflaws and erdlnances gaveming fhls type <br /> oPwork will be completed whetherspec;fied harain ornot. The granting of a permif does not presume to giva suthoAry�o violate or cancel the provis+ons of eny othersfeFe or <br /> /oca!!aw regulating constnrction or the psrformance of oonstnrction. Thet�am eufhonzad by tne owner o/thrs praperfy to pe+form tha work�or which appliestion is mada and! <br /> comply with thB SYate Cantractors Law l8,27 RCW and 296.200 lNAC. <br /> City vf E�erett ofiiCla!USB ORry <br /> P�RMIT# <br /> � �z�lt-� � 1 ��f -- l [ <br /> Owner/Autho Agent Signaturo Ddte (Revised 8i23/20?B) <br />