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OCT-1-2015 07:22A FROM:DAHL ELECTRIC-EOERET 425-252-2999 TO:4252579957 P.1/1 <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 /> l rj' v,neE r i A Var <br /> PROJECT ADDRESS <br /> rlk,40 694(,-)DAN ASSSro4ay 1! V cyer.t7- _ l✓� q�1�l �,,�s-3�i-3�3 <br /> Owner Mail Address City State/Zip Phone <br /> 5 xot.,<C <br /> Tenant Mail Address City State/Zip Phone <br /> DSL E1,ECT1LlL .34011 McOPU&ALL. Ayi Eur-,wir 9%jD1_ 411 r- Q I'oa <br /> Electrical Contractor Mail Address City State/Zip - Phone <br /> QA14LEE1C1IL.08 02) -761Ll <br /> State License Number(required) City of Everett Business License Number(required) <br /> 4"/ MoD " <br /> Proposed Use of Building Contract Price of Work <br /> &kw ,STcuagi .2L ) `l,G1 --DS!1 <br /> dskGVLNSeejp- .tarn <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: ,5T-P&44�4�_ 400 PI <br /> �b40 )CCC,1°7-14CLES 4- L16 NTI <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certify that l have read and examined this application and know the sam&.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 tam authorized by the owner of this property to perform the E <br /> work for which application is made and I comply with the State Contractors Law 16.27 RCW and <br /> 296.200 C. <br /> Signature Date <br /> REVISED 0&042014 <br />