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��--� 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 I www.everettwa.gov/permits <br /> PROJECT.SITE INFORMATION <br /> PROJECT ADDRESS: *,"4 S - <br /> BUILDING AREA(if residential, new construction,remodel,or addition) SF <br /> BUILDING TYPE: FR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> q' � <br /> USE OF BUILDING: = 1 NA Am'rj <br /> ELECTRICAL;APPLICATION:INFORMATION <br /> CONTRACT PRICE OF WORK:$ \Ik Q <br /> NUMBER OF DEVICES(if low voltage): <br /> FIRE ALARM? 0 YESNO <br /> ASSOCIATED BUILDING PERMIT# if applicable): <br /> DESCRIPTION OF WORK: t.,-111I.`voU ,{ 6��jri.t'1 4_11_1.A/( lip fp,(9 i.§r 'A�.=$— <br /> CONTACT:INFORMATION <br /> OWNER NAME: CDO;AALl Q(1 (Luc, TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET <br /> )Sf <br /> CITY `A LA Q STATE ,4,+ ZIP g, ,er'j <br /> OWNER PHONE:(/(t,' 32-Ar)- 7a OA- <br /> 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 Q 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 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 /> E kZ .2 - b15 <br /> Owner/Authorized A e"t Signature Oat (Revised 923/2016) <br /> g � g <br />