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1340 MADRONA AVE 2019-02-11
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1340 MADRONA AVE 2019-02-11
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2/11/2019 11:40:45 AM
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2/11/2019 11:40:44 AM
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Address Document
Street Name
MADRONA AVE
Street Number
1340
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477, 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 www.everettwa.gov/permits <br /> PROJECT:SITE INFORMATION <br /> PROJECT ADDRESS: t`i ILi I< a:A s1 <br /> BUILDING AREA(if residential,new construction, remodel,or addition) SF <br /> BUILDING TYPE: ,©SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: <br /> :<.ELECTRICAL APPLICATION:INFORMATION ;' <br /> CONTRACT PRICE OF WORK:$ ;t , +0,0 <br /> NUMBER OF DEVICES(if low voltage): <br /> FIRE ALARM? 0 YES i�NQ <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: 0 ; T.)1(;,,rQ ��`J1� s ^.r���{(• <br /> ',`::: ':.:::CONTACT INFORMATION <br /> OWNER NAME: 17. ,l a i�l� �i V ( Ar'k\ALU' {' TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET !=5L-t 0) t�1+;,r^h/U7t)^+Ji <br /> CITY STATE 1 I k r`c Zn, (1.t;t <br /> OWNER PHONE: -* :�" 4In — ' t t I OWNER EMAIL: <br /> CONTRACTOR NAME: G&S HEATING <br /> CONTRACTOR ADDRESS: STREET 3409 EVERETT AVE <br /> cry 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'1 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 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# <br /> E <br /> Owner/Authorized Agent Signature Date (Revised 9/23/2096) <br />
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