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ELECTRICAL PERMIT APPLICATION <br /> a I CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps©O eevverettwa.gov I www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: 9501 19th Ave SE, Everett,WA 98208 <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: 0 COMMERCIAL <br /> USE OF BUILDING: Convenience Store <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK:$ 3s 000 <br /> NUMBER OF DEVICES(if low voltage): <br /> FIRE ALARM? ❑YES ER NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: 26 /aced,- y r 1��� i�S u� � pe,14>_( <br /> CONTACT INFORMATION <br /> OWNER NAME: Pl C-6-45 i Ei43efte04, L L C TENANT NAME(If Commercial): Emanuel IV, LLC <br /> OWNER MAILING ADDRESS: slaw'311 Ste' E- C#1MIK EI C ZAP. CO vial <br /> cm NtE.Ri-bi-Islriv <br /> STATE .TA ZIP 13642._ <br /> OWNER PHONE::y ,Q g)$g '1-6'1q 'OWNER EMAIL: gCAL-CSTAT1E @ J CKSoN(. CO svx <br /> CONTRACTOR NAME: 1414 1 f etc.e.-i b' / ctvtJ S, ✓i) <br /> CONTRACTOR ADDRESS: STREET l71(sG., 17#'' Ave' L+ i . s.A- <br /> C111' <br /> dd Sr <br /> -.-._c1TrSre., 1,4 �..u..,k.`�S _ _.. _ _._. STATe. ic �JT_.. IP g3C� <br /> CONTRACTOR PHONE: 0^-S"3.6,7i- $'121.7 CONTRACTOR EMAIL: kit/ le- 00 i„e, Wt1;I a CO"1 <br /> CONTRACTOR LIC.#(REQUIRED): �k ii,.e..5 9-3, b r ICITY OF EVERETT BUSINESS LIC.#{REQUIRED):(AN <br /> N <br /> PRIMARY CONTACT: %OWNER 0 CONTRACTOR 0 OTHER(Please Specify) 2 ' <br /> CONTACT NAME: CONTACT PHONE: 206_356_1974 <br /> Sami Said CONTACT EMAIL:jean@emanuelinc.com <br /> AGREEMENT:I hereby certify that I have read and examined this application and know the same lobe true and correct All provisions of taws and oninances governing this type <br /> of work will be completed whether specified herein or not The gram of permit does not presume to gwe authority to violate orcarcel the provisions of any other state or <br /> local law regulating construction or the performance of cion. That I am authorized by the owner of this properly to perform the work for which application is made and I <br /> comply with the State Contractors taw 113.2T RCW and 286.200 WAC. <br /> pAtt I esT E'NCtlp�,$,1 LL+-C.. <br /> C" k/S441-plr City of Everett Official Use Only <br /> r" PERMIT# <br /> 0 j. - It--s- 07 Ell {d' OS3 <br /> OwneriAAgent Si Date <br /> (Revised 9/23,2016) <br /> Rots (Za9 w TEC'FETE l4.- Q <br /> its: Ca y- am.) L_ <br />