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ELECTRICAL PERMIT APPLICATION <br /> Ey 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 SITE INFORMATION <br /> PROJECT ADDRESS: f � �(� �. ��(�,� .- y l�_(,�J �w� <br /> BUILDING AREA(if residential,new construction, remodel,or addition) SF <br /> BUILDING TYPE: ❑SFR-DETACHED ❑ SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: � COMMERCIAL <br /> USE OF BUILDING: <br /> ELECTRICAL APPLfCAT10N INFORMATION <br /> CONTRACT PRICE OF WORK: $ `�DD�✓ <br /> NUMBER OF DEVICES(if low volta e): <br /> FIRE ALARM? ❑YES �10 <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: } KJ,� �, I�L R�W L C KTS rp'� S�.i.M.t�^ �„�i�t�s <br /> CONTACT INFORMATION <br /> OWNER NAME: nWl,t/�vt�j TENANT NAME(If Commercial): S8R1G <br /> OWNER MAILING ADDRESS: sTR��r j � .3(j ��f�j'r ,tyj�; �(q;,„/, ��. <br /> CITY r,� �{.�.'C� (T STATE j/ A f ZIP ! ��C� <br /> OWNER PHONE: � S .�� `�' I�(Ir OWNER EMAIL: .�-wte5. �'�rw '� V! �✓.+/t <br /> CONTRACTOR NAME: Dalll EleCtflC, �nC. <br /> coNTRa,croR a��REss: STREET 3409 McDougall Ave <br /> CITY Everett STA,� WA Z,P 98201 <br /> CONTRACTOR PHONE: 425-252-1700 CONTRACTOR EMAIL: dSt@V@tlS@Clafll2l@CtfIC.COfTI <br /> coNTRacroR uc.#�REQuiRE��: DAHLEE1926QD CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 037024 <br /> PRIMARY CONTACT: ❑OWNER �CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 360-661-OS11 <br /> ��all SteV@IlS CONTACTEMAIL: dSt@V@f1S@dahl@I2Ct�IC.COIII <br /> AGREEMENT:1 hereby certify that 1 have read and examined thrs application and know the same to be irue and correct. Alf provrsions of laws and ordinances governing this type <br /> of work will be completed whether specified herein or not. The granting of a permit does not presume to give authority to violafe or cancel the provisions of any other siate or <br /> local law regulating construction or the performance of construction. Th,at I am authorized by the owner of this property to perform the work for which application is made and l <br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> PERMIT# <br /> �. 1 �z - �- l� E �C�(2 -C�� <br /> OwnerlAuthorized Agent Signature Date (Revised 9/23/2016J <br />