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"ow LECTRCAL PEI IT APPLICATION <br /> vitil CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 I (E) everetteps@everettwa.gov I www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION'; <br /> PROJECT ADDRESSN9' ) 4c) <br /> YT P_.--v-c...— <br /> BUILDING AREA(if residential,new construction,remodel,or addition) SF <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED J .DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: p.‘e, ,...1,4, ,...._ <br /> . . . .. <br /> ELECTRICAL APPLICATION INFORIIAATION , <br /> CONTRACT PRICE OF WORK:$ I ogC9C.9 „ <br /> NUMBER OF DEVICES(if low voltage): <br /> FIRE ALARM? ❑YES gI NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): Q <br /> DESCRIPTION OF WORK: -C ---C4 `-t-(( Qet tM;- CVO I C U M 00 3 • <br /> .0 uvve �Gvt c -ram J11tV el.ec. C a.v1 . <br /> CONTACT;INFORMATION <br /> OWNER NAME:Zeboca1 i Ckt,-as-A`;j TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 9J e3O �"A-6 au`(/ <br /> 5,uGre,-4.,v. /_ f 22crry � "� LO ti' STATE ZIP 617#0 , <br /> OWNER PHONE: (e- , v et i -n(0O OWNER EMAIL: <br /> CONTRACTOR NAME: AkabQy\ cil�ekt;G L.C— <br /> CONTRACTOR ADDRESS: STREET 6C9 q pr. t\J (i <br /> CITY 0/ S U tt. k. STATE (k)A.. ZIP o / <br /> CONTRACTOR PHONE: t("a.,� 3K S- (Lep t6 CONTRACTOR EMAIL: (AA.a SCS^.6,Le C -('I`c, [' imv.( .C(J✓� <br /> CONTRACTOR LIC.#(REQUIRED)• ft SOA)G[�(teS -.,7 CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 6'C1L <br /> PRIMARY CONTACT: 1 OWNER 0 CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: n CONTACT PHONE: `�Y'- G('&3,.,i0 6 a G� <br /> Ve (`P� \C..(�,IA-C�i/'(J U CONTACT EMAIL: ,1 A I�Z(1G. ,e t e a(N.`�' t ci Q(- (M pli`t .. C V/k.*-. <br /> AGREEMENT:T hereby certify that I have read and examined this application and know the same to be true and correct All provisions of laws anrddinances governing this <br /> 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 <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 /> FEE <br /> CP <br /> 1 \(_ \0 0 .0-'''''' <br /> PERMIT#r vo - <br /> IIIIIIP tit w o <br /> ��-�- s-av i g Elk) f6()3--61b <br /> er/Authorized Agent Signature Date (Revised 10/12/2015) <br />