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JUL-31-2015 07:32A FROM:DAHL ELECTRIC-EUERET 425-252-2999 70:4252579857 P. 1/1 <br /> • 0 <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 -www.everettwa.org <br /> I D D VCA trr_M/4,L 4t [,,may <br /> PROJECT ADDRESS ^ <br /> IRA y i<'-1rZTL-,--,y <br /> Owner Mail Address City State/Zip Phone <br /> �►�N 7' C01LL"LT— SE 1 D D �ve,,e F 7- M Nc.� t ip Y �v�,e�Ti I'M <br /> Tenant Mail Address City Slate/Zip Phone <br /> DAvI L L-EL TML. -SkDi Mc.OPLL&ALL At/E F ve.,&tr 8vh- 9 g to i y- -2sa-170A <br /> Electrical Contractor Mail Address City State/ZIP Phone <br /> 0A► 1-6-QI g11.Q0 0 2) -7 O 1 L <br /> State License Number(required) City of Everett Business License Number(required) <br /> /, a w p: <br /> Proposed Use of Building Contract Price of Work <br /> 6wm Sr�u�NS 3�� -LGt-DSI► <br /> �STGVGNS�Lt�I LILGl V'IG.0 6YN� <br /> Square Footage(If residential new construction, remodel or addition) Contact Person/Contact Number/Email <br /> Number of devices(If low voltage) <br /> Description of Work to Be Done: �� C I�C u 1 TS 1cO� bFl=/G C Lcrj ICL�`$ <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 6 <br /> 1 hereby certify that l have read and examined this application and know the some to be true and L <br /> correct. All provisions of laws and ordinances governing this type of work will be completed <br /> whether specified herein or not. The granting of a permit does not presume to give authority to PERMIT# <br /> violate or cancel the provisions of any other state or local law regulating construction or the <br /> performance of construction. That/am authorized by the owner of this property to perform the <br /> work for which application is made and/comply with the State Contractors Law 18.27 RCW and <br /> 296.200 W <br /> Signatu Date <br /> REVISED O"62074 <br />