Laserfiche WebLink
/111j-1 ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 ( FAX 425-257-8857 I (E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> PROJEC y T <br /> :..::>::.: ::::.::::: :::.:::...: :..........::..::::.-:.:::::. INFORMATION-.-,:::.:;: ..::;::;;. . :......:::,:,:: :::.::..,,::::.:::.: ... <br /> PROJECT ADDRESS: cb ? .r(:r te,;, '� ,c�� �• <br /> BUILDING AREA(if residential, new construction, remodel, ..ition" SF <br /> BUILDING TYPE:,SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: VIA "�� ,; ) <br /> <.; '::.:.:ELECTRICAL-APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK: $ 1,(\b <br /> NUMBER OF DEVICES(if low voltage): <br /> FIRE ALARM? 0 YES p NO <br /> ASSOCIATED BUILDING PERMIT# f applicable): <br /> IR <br /> DESCRIPTION OF WORK: \f Ark, r; <br /> CONTACT INFORMATION <br /> OWNER NAME: Apr - TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 1E-&2/1:14,-CD''$ l..`-' <br /> C�'_Tv°y�y f�j��. (j;,,) p t 7 <br /> cITVSTATE A ZIP <br /> OWNER PHONE: GO OWNER EMAIL: <br /> CONTRACTOR NAME: G&S HEATING <br /> CONTRACTOR ADDRESS: STREET 3409 EVERETT AVE <br /> crrr 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 Q CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 425-252-4402 <br /> DAVVN 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 /> PERMIT#if <br /> E Ibt4 <br /> Owner/Authorized Agent Signature Date (Revised 9/23/2016) <br />