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E��CTRICAL PERMIT AP�ATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 320Q CEDAR STREET, EVERETT, WA 98201 <br /> (P) 425-257-8810 � FAX 425-257-8857 � (E) everetteps@everettwa.gov � www.everettwa.gov/perrr�its <br /> PROJEGT SITE INFORMAT�ON <br /> PROJECT ADDRESS: �}� ���ng�,, l �J:�f <br /> BUILDING AREA(if residential, new construction, remodef, or addition) SF <br /> s <br /> BUILDING TYPE: �5FR-DETACHED 0 SFR-Al-1'ACHED ❑ DUPLEX �MULT]-FAMILY-#OF UNITS: � COMMERCIAL <br /> USE OF BU1LDl�G: �' !;,"t �r��°1� f° g4 <br /> ELECTRIGAL APPLfCAT10N 1NFORMATION ` <br /> CONTRACT PRICE OF WORK: $ � � �o- <br /> NUMBER OF DEVICES if low volta e): <br /> s <br /> F1RE ALARM? 0 YES ,,�� NO <br /> ASSOCIATED BUILDING PERMIT# if a plicable): <br /> DESCRIPTION OF WORK: <br /> ^�:i y'���: '�`�' �.i��.�✓ <br /> CONTACT INFORMATION <br /> OWNER NAME: ' �L -� TENANT NAME(If Gommercial): <br /> OWNER MAILING ADDRESS: s�tE�'r ; ��,�' ;�'l .r�,t,�, <br /> r � STATE� ZIP���P„�v � <br /> CITY �i�� �� <br /> OWNER PHONE: `�'lZ�'' ����'��`4�� OWNER EMAIL: <br /> CONTRACTOR NAME: G&S HEATING <br /> coNrr�acTOR Aoo�ess: sTREET 3409 EVERETT AVE <br /> �,r. EVERETT STqTE WA z3P 98201 <br /> CONTRACTORPHONE: �25-252-4402 caNrRacroREnrtai�: DAWN@GSHEATING.COM <br /> coNr�,croR uc.#�REQuiRE�y: GSHTGSH930RK CI7Y OF EVERETT BUSINESS LIC.#(REQUIRED): a�9685 <br /> PRIMARY CONTAGT: ❑ OWNER �Zl CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: [}�5_252-4402 <br /> DAWN WEIMER coNTacrFnna,i�: DAWN@GSHEATING.COM <br /> AGREEldEN7:1 hereby cetrfy tha!!have read and examrned this applicafion and know the same to 6e tnfe and corrsct. Al!provisions otlaws and ordinances goveming fhis type <br /> of work v✓i!(be compieted whefher specified h=rein or not. The granting of a permit does not p2sume to give authonty fo viclate or cancel the provisions of any oiher state cr <br /> loca!!aw regulat.�ng c�nstruction or the perfornarce of consfruction. That!am authorized by the ov✓ner of this prope�ty to perform fhe work for which application is made and 1 <br /> comply w.�th fne Sfate Contrectcrs Law 1827 RCW and 296200 WAC. <br /> City of Everett O�cia!Use Only <br /> '� PERM IT# <br /> ������ � �, � � E ��` C��� ����`1 <br /> ��� � - <br /> Owr�erlAuthorized Agent 5ignature Date !Revised 9/23/2016) <br /> __.. _..... . _...... . ........._. __... __ ._.._..__._ _._ __ . _.._....____ --- ____ .. _ _ _...... . _ _ _ _ <br />