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4E77ELECTRICAL PERMIT APPLICATION <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@everettwagov( www.everettwa.gov/permits <br /> PROJECT:SITE:INFORMATION .` <br /> PROJECT ADDRESS: ,r`;3:} ç \Q!\4 ;A �• <br /> BUILDING AREA(if residential,new construction, remodel,or addition) SF <br /> BUILDING TYPE: JI SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: <br /> :<: EL <br /> TR C <br /> .::. :-:.:;;:. ::.:. :::::.;:.:::- ,:: :::;-;:. ....::::: I AL..APPLICATCONINF.ORMA: ;::;; ` ;:;:: i' : , :. :;::';; :::t :: ;:;;;;;' ::::<:: : <br /> -:..:.: . TION.: _. <br /> CONTRACT PRICE OF WORK:$ 1, [; 'v <br /> NUMBER OF DEVICES (if low voltage): <br /> FIRE ALARM? 0 YES , 1 NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: P�,� ,f,„r^;; '(�-,;t;^11 e7.4?_. <br /> T.. NF: `CONTAC TON:; :;.>:;:;:;:' :<::: :::: : ::::: :: ;_.:+; ;:s:<:_ : :; `;;:;;;: ;.: :; <br /> OWNER NAME: \k '1U(\ (:Ar\.pj,.'r\ TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET } ) '`-c,.Af1,rA.A_.-c, <br /> cry ST"---,t:a h Lk' STATE :Ll,'\ zta '$i-7 ) <br /> OWNER PHONE: CV - )7AC:1-- C.vP OWNER EMAIL: <br /> CONTRACTOR NAME: G&S HEATING <br /> CONTRACTOR ADDRESS: STREET 3409 EVERETT AVE <br /> CITY EVERETT STATE WA zip 98201 <br /> CONTRACTOR PHONE: 425-252-4402 CONTRACTOR EMAIL: DAWN@GSHEATING.COM <br /> CONTRACTOR LIC.#(REQUIRED): GSHTGSH93ORK CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 019685 <br /> PRIMARY CONTACT: 0 OWNER 10 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 425-252-4402 <br /> DAWN WEIMER CONTACT EMAIL:DAWN@GSHEATING.COM <br /> AGREEMENT:l hereby certify 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 <br /> of work wilt 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 lam authorized by the owner of this property to perform the work for which application is made and! <br /> comply with the State Contractors Law 18.27 ROW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> //1 PERMIT# <br /> . 1 ' k E Iq:1Q' a 056' <br /> Owner/Authorized Agent Signature Date (Revised 9/23/2016) <br />