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SEP-1-2015 11:51A FROM:DAHL ELECTRIC-EVERET 425-252-2999 TO:4252578857 P. 1/1 <br /> 0 --9 <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 /> � �. S i,✓ � v�=r2t�-r� -AGN(.L �✓13y <br /> PROJECT ADDRESS <br /> F t=D►2tQIQ i ,j TD�2�G L- Gt 2 2 S11! 1�,/ MALL 4),4y 64,.,,er qV O y <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> l A&AL EL.ECTOLtL .340A MI-0014 ALL Avi fur-PAC r 9,9 2o 51r-2sj 17aa <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> 0A4LEEt "111,00 0 2) -7 Q 14 <br /> State License Number(required) City of Everett Business License Number(required) <br /> Proposed Use of Building Contract Price of Work <br /> dr�u S11�u��ts3�I� -LGt-Ost► <br /> IJIS�GVLNdCf��f.hl��LC�hIG.C6Y►1 <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: ►Q GI t2Gu,cT.S OIL �FGwi�( 7- <br /> C SAIF 44S <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 14 (�(r� <br /> 1 hereby certify that/have read and examined this applicationand know the same to be true and <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 E j L�Cq l Fl1,/`(� <br /> work for which a licalion is made and l comply with the State Contractors Law 18.27RCand l lJ I (� I <br /> 296.200 Ile <br /> 9 - 1 - Is <br /> — AA —Z2L <br /> Signature Date <br /> REVISED 0"&2014 <br />