3319 FEDERAL AVE 2019-03-21 - Laserfiche WebLink

ELECTRICAL PERMIT APPLICATION __/11j" CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 I FAX 425-257-8857 F (E)everetteps©everettwa.gov( www.everettwa.gov/permits p :_ : ;:. .ROJECT::SITE.:INFORMA ....,................::. .....:....::...:.... PROJECT ADDRESS: .5\e'l Ty 4767_9“--- BUILDING 9“--- BUILDING AREA(if residential, new construction,remodel,or addition) SF . BUILDING TYPE: CJ/SFR-DETACHED 0 SFR ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL USE OF BUILDING: 1\6"e•erlicia f ELECTRI ATION.INFORMATION::::..;:. CONTRACT PRICE OF WORK: $ j ()i NUMBER OF DEVICES(if low voltage): FIRE ALARM? ❑YES ❑NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: !Lt.')I c r Cp_AA .-rn& rirl 061 a1 r( -t t C2s'1✓ s.4— z I - CONTACT:INF OWNER NAME: k-;7 Pv,;, e; \ r,STENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET -{-IP,1_0X 0.-k‘ r CRY l�..t!'�t.e - s s i,: ZIP %742-(( OWNER PHONE: 7g-s--(e) OWNER EMAIL: • CONTRACTOR NAME: GS HEATING CONTRACTOR ADDRESS: sTREET 3409 EVERETT AVE yin EVERETT STATE WA ZIP 98201 CONTRACTOR PHONE; 425-252-4402 CONTRACTOR EMAIL: DAWN@GSHEATING.COM CONTRACTOR LIC.#(REQUIRED): GSHEAHC8218R CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 60058 PRIMARY CONTACT: ❑OWNER rd CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 425-252-4402 DAWN WEIMER CONTACT EMAIL:DAWN@GSHEATING.COM AGREEMENT:I 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 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 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! comply with the State Contractors Law 18.27 RCCW and 296.200 WAC. City of Everett Official Use Only r PERMIT* ��.---� IILS 11 E - 1 Cof6 Owner/Authorized Agent Signature l Date (Revised 9/23/2016)