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/—_� ELECTRICAL PERMIT APPLICATION, <br /> .V- - CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P) 425-257-8810 1 FAX 425-257-8857 I (E)everetteps@everettwa.gov 1 www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: 3 $ l 4 -.SM.f t H AWL" i 6-66- 8 <br /> BUILDING AREA(if residential,new construction,remodel,or addition) SF <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: E COMMERCIAL <br /> USE OF BUILDING: ..S rois-AG6. UN crS <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK: $ gip`v <br /> NUMBER OF DEVICES(if low voltage): <br /> FIRE ALARM? 0 YES E NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: A.100 C'' w-vr- Pvrt S c ci—. e-L If G)4s1,&4_.v}S <br /> Om 8 IAA 4_6 146-- 3 <br /> . CONTACT INFORMATION : - <br /> OWNER NAME: f3J41_ IE S-TI,..,4 TENANT NAME(If Commercial): Same <br /> OWNER MAILING ADDRESS: STREET r- <br /> ill <br /> 31. <br /> fica.Eea. <br /> CITY !�-V44iQ/a1. P STATE 1441— / ZIP �j tt2-4)(OWNER PHONE: lac "a30, "- 1 5-63-tc OWNER EMAIL: es ter l ; iii'J ya 4.ap_Coon <br /> CONTRACTOR NAME: Dahl Electric, Inc. <br /> CONTRACTOR ADDRESS: STREET 3409 McDougall Ave <br /> CITY Everett STATE WA ZIP 98201 <br /> CONTRACTOR PHONE: 425-252-1700 CONTRACTOR EMAIL: dstevens@dahlelectric.com <br /> • <br /> CONTRACTOR LIC.#(REQUIRED): DAHLEE1926QD CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 037024 <br /> PRIMARY CONTACT: 0 OWNER ®CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 360-661-0511 <br /> Dan Stevens CONTACT EMAIL:dstevens@dahlelectric.com <br /> 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 <br /> 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 <br /> local law regulating construction or the performance of construction. That I am authorized by the owner of this property to perform the work for which application is made and I <br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> / <br /> PERMIT# <br /> 49— 5-- / 7 E 1601- 012 <br /> Owner/Authorized Agent Signature Date . . .(Revised 9/23/2016) <br />