Laserfiche WebLink
ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 I (E) everetteps@everettwa.gov I www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: yG92. Celt(, <br /> BUILDING AREA(if residential,new construe ion,remodel,or addition) SF <br /> l� <br /> BUILDING TYPE: SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS:, 0 COMMERCIAL <br /> USE OF BUILDING: az`d <br /> ELECTRICAL APPLICATION INFORMATION... <br /> CONTRACT PRICE OF WORK: $ Ct)r C):) <br /> NUMBER OF DEVICES(if low voltage): , <br /> FIRE ALARM? 0 YES 11NO <br /> ASSOCIATED BUILDING PERMIT#6 applicable): <br /> DESCRIPTION OF WORK: L4VtU i4 --re ,, <br /> KV* <br /> CONTACT INFORMATION <br /> OWNER NAME: Z1( \, r�,i(,i�q�'- TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET q e0 3 ('.n t (A.a AlSt-- <br /> gy— u rr <br /> CITY Taj(,(4,0A STATE ( ,-- ZIP g'�7�1 <br /> OWNER PHONE: qt\ '1l. Z' d n.sem 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 0 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 425-252-4402 <br /> DAWN WEIMER CONTACT EMAIL: DAWN@GSHEATING.COM <br /> AGREEMENT.I hereby certify that!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 1 em 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 /> PERMIT* <br /> (IN is/ E M05-0°15' <br /> Owner/Authorized Agent Signature Date (Revised 9/23/2016) <br />