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I <br /> gn. 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 /> >PROJECT SITE.INFORMATION . <br /> PROJECT ADDRESS: tilos-" (- t i I'a\fey) -or. // A/9Pe <br /> (i ��K7 �- <br /> BUILDING AREA residential,new construction, remodel,or addition) SF <br /> BUILDING TYPE: tIR-DETACHED ❑SFR-ATTACHED 0 DUPLEX El MULTI-FAMILY-#OF UNiTS: 0 COMMERCIAL <br /> USE OF BUILDING: <br /> .-. ::::::; ;;,'.. : ::.::.::7 .: ELECTRICAL::APPL ............._..,.::. .....,:.::::..• : ......:.:. ::::. <br /> <:.:.:::;:::.:::::.::. , ; : :;; :: ::.::::::. KATION.:INFORMATION::::....::.:._.::.: .: ... ..:. ..,;.;...,.:,:: ;:... ,,_.. ....: <br /> CONTRACT PRICE OF WORK:$ .17 its--- <br /> NUMBER OF DEVICES (if low voltage): <br /> FIRE ALARM? 0 YES ❑NO <br /> ASSOCIATED BUILDING PERMIT# if applicable): <br /> 3 <br /> DESCRIPTION OF WORK: pay In y e,C± tri r-L �t LA I v'c L- 4- f Vk f-'' i► (. <br /> U <br /> Co <br /> .... ,.. ACT:INFORMATION:: <br /> OWNER NAME: Pip,l,y�-�,� � <br /> Q 4 K r, - l(elENANT NAME If Commercial): <br /> OWNER MAILING ADDRESS: V STREET 4.--70s- _-j Z.6 vex)i !cam v- <br /> CTY C/� e/ STATE L-) 01 ZIP ' dJ .E../ <br /> ed <br /> OWNER PHONE: ,f- 0(12 4c/ © J P�1 OWNER EMAIL: <br /> CONTRACTOR NAME: G&S HEATING <br /> CONTRACTOR ADDRESS: STREET 3409 EVERETT AVE <br /> crry 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 71 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 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 t am authorized by the owner of this property to perform the work for which application is made and 1 <br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> 1. / 7)(2PERMIT# <br /> :i / i 11(' -; V; <br /> , ',� E l g -o te 9-- <br /> Owner/Authorized Xge ttigneitiire i I Date (Revised 9/23/2016) <br />