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Jul. 21. 2017_ 3: 04PM No. 5589 P. 1 <br /> Oren- LECTRICAL PERMIT A_ LICA.1 ION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P) 425-257-8810 1 FAX 425-257-8857 J (E) everetteps@everettwa.gov J www.everettwa_gov/permits <br /> PROJECT SITE INFOR TION <br /> PROJECT ADDRESS: V r\ 1,U,' S _ <br /> BUILDING AREA(if residential, new construction, remodel, or addition) ( 0 SF <br /> BUILDING TYPEFR-DETACHED ❑SFR ATTACHED ❑ DUPL El MULTI- AMILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: ' ,c)\cIQ}.1 `k LZJ _ <br /> ELEC11ICAL APPLICATI 'N INFORMATION <br /> CONTRACT PRICE OF WORK: $ \ 0 . L C G , Co <br /> NUMBER OF DEVICES(if low voltag_ • <br /> FIRE ALARM? ❑YES 7 NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: U 1. ( \(pINA I14(.Q_( 4, [)i- cr_)(/L(kar�.{ .. <br /> t d <br /> _v ,€,Qi-v r r:. C , f-iv.,, il. \,/k_t.t t.:,-k�.11_4— <br /> • <br /> CONTACT INFORMATION <br /> OWNER NAME: IA.&t\j C \\z!\.? W TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET '\.-1, \ is,o }— <br /> CITY .aCts <br /> ) (JAA- (), STATE ZIP <br /> OWNER PHONELQ 7)U(0— }- '� 44 cOWNER EMAIL: <br /> CONTRACTOR NAME: G&S HEATING <br /> CONTRACTOR ADDRESS: STREET 3409 EVERETT AVE <br /> cm, EVERETT STATE WA zip 98201 <br /> CONTRACTOR PHONE: 425-252-4402 CONTRACTOR EMAIL: DAWN@GSHEATING.COM <br /> 1. <br /> CONTRACTOR LIC.#(REQUIRED): GS,HTGSH93ORK <br /> PRIMARY CONTACT: 0 OWNER ®CONTRACTOR 0 OTHER <br /> CITY OF EVERETT BUSINESS LIC.#(REQUIRE ; Q19865 <br /> (Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 425-252-4402 <br /> DAWN WETHER CONTACT EMAIL: DAWN@GSHEATING.COM <br /> AGREEMENT:t hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws end ordinances governing this type <br /> of work will ba 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 em 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 298.200 WAC. <br /> City of Everett Official Use Only <br /> • <br /> PERMIT# <br /> --1 ,7An E \q0q - k55 <br /> Owner/AuthorIzed Agent Signature Dae (Revised 9/23/2016) <br />