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ELECTRICAL PERMIT APPLICATION- � -- <br /> �y CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 � FAX 425-257-8857 � (E)everetteps@everettwa.gov ( www.everettwa.gov/permits <br /> PROJECT StTE INFORMATION : <br /> PROJECT ADDRESS: �j(�(� I �Y� �1 CJ�`� <br /> BUILDING AREA(iF residential,new construction,remodei,or addition) SF <br /> BUILDINGTYPE: ❑ SFR-DETACHED ❑SFR-ATTACHED ❑DUPLEX ❑ MULTI-FAMILY-#OF UNITS: COMMERCIAL <br /> USE OF BUILDING: �' T�/,���/�' <br /> ELECTRICAL APPLCCATION INFORMATION <br /> CONTRACT PRICE OF WORK: $ I !�(�¢� <br /> NUMBER OF DEViCES(if low volta e): <br /> FIRE ALARM? ❑YES C�'1G0 <br /> ASSOCtATED BUILDING PERMIT# if applicable): <br /> DESCRIPTION OF WORK: ��� (,.�'G-6�7�" �L✓�TGl-f �eS %!,� �1�"1 �?"�C/►/w° �l!(�Ti�l <br /> : � . CONTACT INFORMATION <br /> OWNER NAME; (J01�(r �/�� ,� L� �,L''�'ENANT NAME(!f Commercial): S2►112 <br /> OWNER MAILING ADDRESS: sTReer .�U!�°� � `� rk S1" S�: <br /> cirv �OTl�r6L STATE I7/�" ziP �,�o.�I <br /> OWNER PHONE: �fa s���/ - ���Gi OWNER EMAIL: <br /> CONTRACTOR NAME: Dahl Electric, Inc. <br /> CONTRACTOR ADDRESS: sTReeT 34�9 MCDOUgaII AV2 <br /> c,T., Everett STATE WA Z,P 98201 <br /> CONTRACTOR PHONE: 425-252-1700 CONTRACTOR EMAIL: dSt2V@tlS C�l CIaIIIE'.I@CtfiC.COt71 <br /> coNTtzacTOR uc.#�REQuiREo�: DAHLEE1926QD CITY OF EVERETT BUSiNESS LIC.#{RE(2UIRED): 037024- <br /> PRIMARY CONTACT: ❑OWNER �CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 36Q-�61-0511 . <br /> Dan Stevens coNTacT Ennai�: dstevens@dahlelectric.com <br /> AGREEMENT.I hereby certify that I have read and examined thrs application and know the same to be true and correct. All p�ovisions of laws and o�dinances governing this type <br /> of work will be completed whethe�specified he�ein or not The granting of a pe�mit does not presume to give authority to violate o�cancel the provisions of any other state or <br /> /ocal/aw regulating construction or the performance of construction. That I am authorized by the owner of this property to perfo�m the work for which applicatron is made and l <br /> comply with the State Contractors Law 98.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> PERMIT# <br /> �-G -� � E ��D �- o3C� <br /> _ <br /> Own uthorized Agent Signature Date (Revised 9/23/2016) - <br />