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4:En- PLECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 1 FAX 425-257-8857 (E) everetteps@everettwa.gov I www.everettwa.gov/permits <br /> PROJECT:SITE:INFORMATION <br /> PROJECT ADDRESS;,-/t rhe c -int <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: �( 0 I,1l^ <br /> ; ': ::::;:ELECTRICAL:APPLICATION.INFORMATION <br /> CONTRACT PRICE OF WORK: $ E, <br /> NUMBER OF DEVICES(if low voltage): <br /> FIRE ALARM? 0 YES 0 NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: I n5--171 19 Icy- r o k (-).3rvi u�I zr; — a.9I �G'� .c yve(2 0 <br /> CONTACT INFORMATION <br /> OWNER NAME:I2( ftjvt. T;\i riPt,l'iTENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET f . d; ingst(-Not <br /> • <br /> 4,t <br /> CITY Eijk2tt d STATE vf'4f i"fi ZIP t-- ,/1,3./R. <br /> OWNER PHONE: 1c_!^ sit -� 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 CONTRACTOR ❑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 I 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 /> Owner/AulAorized Ag nt Signature Date (Revised 9/23/2016) <br />