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�L�CT�IC.�L P���lT ���'LlCAT��� <br /> � CI i Y OF EVERETT PERP�11 i SERVICES <br /> 3200 CFDAR STP.EET. EVERETT VV,1 98201 <br /> (P) 425-257-0810 � FAX �125-257-�857 � (Ej everatteps@eve;ei�Na.gov i wti�r�v.everei��va.cov/perrniis <br /> PRO,lECT SITE I�I�ORMATiOP! <br /> PROJECT ADDRESS: � � �j j �,(�K� �-�� �� '�'"S j�k� <br /> BUILDING AREA(if residenticl, new construction. remodel. or ar+dition)___ SF <br /> BUILDfNG TYPE: ❑ SFR-0ETACHED ❑ SFR-ATTACHED ❑ DUPLEX ❑ NIULTI-FAA�IILY-;+OF UNITS ___ LyCON11V1tRC1,4L <br /> USE OF BUILDING: ��t�, ��T' %�� ��/ �I t�G�� <br /> / <br /> 'E ECTl�1CAL APPLICATION 11dFOitiNAT1ON <br /> .� .� .�, ;� <br /> CONTRACT PRICE OF WORK: � � � L�L-' ; _ <br /> � <br /> NUMBER OF DEVICES (if Iovv voltage):� � <br /> �` <br /> FIRE ALARM? ❑YES O �' <br /> ASSOCIATED BUILDING PERMIT# (if applicable): <br /> DESCRIPTION OF WORK: y1 � �� ��f�lV� /�/c �=.NCr� iLi.l L�T <br /> f -�t��.i. .'-✓���" 5 <br /> GORITACT I�+JFOR�1/1ATfOP! <br /> OWNER NAME � T'ti A/y�J (� ln/ TENANT NAME(IF Commerciai): S7t71e <br /> OWNER MAILING ADDRESS: srREET /M(? r�JOw �,� 1� � <br /> � � /� �Q/ <br /> �:ITr /_ �"�GLn 7� STATE �/!�'�� ZIP � ( <br /> o4�rrirF =�f�or�F- _�1�.}"`�51 � G� `lD� --^ ,o�,vr�FFz ��,nni� �J9t�"r"l�lGwl��-_. ����ktiw �...�,,. v.�'. <br /> ___ . r <br /> CONTRACTOR NAME ���hl �IeGtriC. InC. <br /> CONTRACTOR ADDRESS: - _-- 3`�O� NICDOUC��II AV� <br /> ,,ir.� Eve�ett sT.aTF_ WA zia 98201 <br /> CONTR.ACTOR PHONE ��5-252-1700 CONTRACTOR EP�IAIL dSt�V2flS�daIlI2I2CtCIC.COfTI /� <br /> CONTRACTOR LIC.#(R��Ui�ED): D;�HLELIJ2C�QD CITY OF EVERETT BUSWESS LIC.#{REUUiRE ): UJ%OZ4 � <br /> PRIMARY CONTAGT: ❑ O�PhVER �L7 CONTRAC�OR ❑ O i HcR(Please Specf^�) �'`� <br /> CONTACT NAME: CONTACT PHONE: 360-6(j1-O511 <br /> Dan Stevens co�TacT EMai�: �stevens@dahlelectric.com <br /> A�REEME��/T�1 hereby cerb"ry Ihat 1 nas�e�ead and axamined fhis 2pp�icalicn�nd kno���tne sarne to be fn�e ar,d corr=cL All provisions o/la�ris ard ordinances govFming fh�s type <br /> o/work�vlll be comple;ed whr(her;peaiied here�n o�nr,t. The granr�ny oi a panrnf does not presume�o r,ive authonty ro violate or cancel the provisions o7 any ofher sPale o� <br /> lu�al law�egulaling consfruchen or(he pen`ormance oi const�uctron Th�t 1 am aurho�ized by lhe oVrne�o�lh�s p�opa�ty to perform the work io�which application is made anti l <br /> cornply•.vifh the Siafe Con(racfors Lasv l;i'�'i RCL^J�nJ 246�GO W;IC <br /> ��ry ol Eva�alt Ofnr-ral 1/se Onl� <br /> . _ PERMiI# <br /> _ , �. ; � - � 2 > >>_�-,_- � ��-1 2- �2� <br /> O�rvne��iAuthorize�i Agent Slgn�[ure -- -- D�le (ReviSed 9/23i201ti) - <br />