615 80TH ST SW 2022-01-03 - Laserfiche WebLink

ELECTRICAL PERMIT APPLICATION _ Ey CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P) 425-257-8810 FAX 425-257-8857 1 (E) everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: l S� p T14- �T BUILDING AREA (if residential, new construction, remodel, or addition) SF BUILDING TYPE: ❑ SFR-DETACHED ❑ SFR-ATTACHED ❑ DUPLEX ❑ MULTI -FAMILY - # OF UNITS: 1! COMMERCIAL USE OF BUILDING: k/Ae-C140 St ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ 14 3 vv NUMBER OF DEVICES if low voltage): FIRE ALARM? ❑ YES El'*N'-O ASSOCIATED BUILDING PERMIT # if applicable): J3 0,3 DESCRIPTION OF WORK: L.1&14T--S Ot4rTLa1d �EX14.4 64VS C.ONTACT.INFORMATION OWNER NAME: 100C&C—t/c kAz4tl(y- ZAd-us TENANT NAME (If Commercial): Same /i OWNER MAILING ADDRESS: STREET 6 I S- e61)" S T— SU CITY Evr-_zt rr STATE W ZIP 4) 92D OWNER PHONE: 1041 OWNER EMAIL: CONTRACTOR NAME: Dahl Electric, Inc. CONTRACTOR ADDRESS: STREET 34-09 McDougall Ave CFTY Everett STATE WA zip 98201 CONTRACTOR PHONE: 425-252-1700 CONTRACTOR EMAIL: dstevens@dahlelectric.COm CONTRACTOR LIC. #(REQUIRED): DAHLEE1926QD CITY OF EVERETT BUSINESS LIC. #(REQUIRED): 037024 PRIMARY CONTACT: ❑ OWNER ® CONTRACTOR ❑ OTHER (Please Specify) CONTACT NAME: Dan Stevens CONTACT PHONE: 360-661-0511 CONTACT EMAIL: dstevenS@dahlelectric.com AGREEMENT: I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be completed whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction. That/ am authorized by the owner of this property to perform the work for which application is made and/ comply with the State Contractors Law 16.27 RCW and 296.200 WAC. Owner/Authorized Agent Signature -7_16_ / 7 . Date F _,...._ - City of Everett Official Use Only PERMIT # (Revised 912312016)