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�lun, �, 2017 1 ; 58PM No, 5428 F, i <br /> ELECTRICAL PERMIT APPL1CATlON <br /> C1TY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 9B201 <br /> 425-257-8810 � FAX 425�257-8857—www.everettwa.org <br /> 1Q�� R�l <br /> PROJECT ADDRESS <br /> � <br /> E.ri�._P�l� I o�� " r�� -i��� E V�,��}- w►� UR;�o� <br /> OWner Mail Address City State/Zlp Phone <br /> �O�rw'c. (��� �.�-�ev� . <br /> v <br /> Tensnt Mall Address City Stale/Zip Phone <br /> G&S HEATING 3g09 EVERETT AV� EVERETT, WA 98201 425-252-4402 <br /> ��oCtflCal ContfaCtOf Mai1 Address City State/Zip Phone <br /> GSSHTGSH939RK 019685 <br /> State Llcense Number(requfred) Cify of�verett gusiness License Number(required) <br /> F2ESIDENTIAL I(����Q�,"1. U� <br /> Prop d Use of Building Contract Price of Work <br /> ���'" <br /> DAWN WEIMER 425-252-4402 <br /> i y�are�ootage(If residentlal new consfruction, remodel or addition) Contact Person/Contact Number/Email <br /> i <br /> � <br /> � <br /> �" <br /> Nu er ofsc�evices(If Iow voltac�e) <br /> bescription of Work to Bo bone; �f1�� �"�nf`e `��,�)1 (`�d <br /> FEE <br /> CITY OF EVERETT LOCAL 5ALE5 TAX COLIE 15 3705 � 1�� + C � <br /> I hereby certify fhat I have read and examinvd this application and know the same to be true and (, <br /> correct. All provisions of laws and orrlinances goveminy this type of work wl!!be completed <br /> whBtHerspecifred herein pr naf. The gr�nting of a pem�it does nof presume fo give aufhorify fo P�RMTT# <br /> violafe or cancel the provisions of any other state or loca!law regulefing construcfion or the � � �O _ <br /> performance of construction. Thaf I am autho�zed by fhe owner of fhis praperty to perform the <br /> work for which appl�cation�s made and I comply with fhe Stafe Contractors L�w 98.27 RCW and <br /> 296.200 WAC, <br /> TtiL � — � ' � <br /> Siflnatu e Date <br /> R�V1SE0 08/OG/2014 <br />