909 SE EVERETT MALL WAY IIZUNA CIDER 2019-09-05

03/'14/2019 08 : 00 #4081 P. 001/001 ,� ELECTRICAL PERMIT APPLITION _ �� CITY OF EVERETT PERMIT SERVICES • 3200 CEDAR STREET, EVERETT,WA 98201 (P)425-257-8810 I FAX 426-267-8857 I(E)everettepsfgeverettwa.gov 1 www.everettwa-gov/Permits .v. ,d ,c � _!y. . 'a ,af . •:r-•, PROJECT ADDRESS: 909 SE EVERETT MALL WAY A- /g y BUILDING AREA: sq ft PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ ADDITION TENANT IMPROVMENT ❑ REMODEL BUILDING USE: ❑SFR ❑ TOWNHOUSE 0 DUPLEX ❑ADU ❑ MULTI-FAMILY-#OF UNITS: ❑ COMMERCIAL �q Ijn 1W9x Yy .._ — 'Y'—W�... r,...Ir..• yr. .1 ...,.�,.. �_ti ..r.4ry 1. y... ��`..v�r �•�y--;••6'�1' —4 YY".f uts4' tan..yr :':lt.'3.res. '.La;,F"� ,•,I::j.:, wv., r r s1=r'r"':�i: ,i., f"' -.:�Y r_ CONTRACT PRICE OF WORK:$ 15000 1ASSOCIATED BUILDING PERMIT#(if applicable): ?, let Di_ 015 DESCRIBE SCOPE OF WORK: ADDED 400 AMPS SERVICE FOR CIDER DRINKS THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ❑ NO 0 YES-Select Scope: 0 Service ✓❑ Feeder ❑ Circuits-#: ❑Complete Re-wire LOW VOLTAGE WORK? Q NO ❑YES-#of Devices: SELECT SCOPE(REQUIRED): ❑ Data ❑ Intercom ❑ Thermostat ❑Audio El Secure Access ❑ Security System ❑ Fire Alarm-Installations under this permit only include electrical wiring rough-in of the system.An additional Fire Alarm Permit is required for review of device location and installation approval. ❑Other(List All): a.0f2 AVbf n",rr;1 (✓l 117.fiH!"�P f i' IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH ANO/OR PERSONAL CARE FACILITIES: El NO ❑YES—See Below&Pg. 2 By checking this box, I am stating that I have read and understand all of WAC 29-646B-900,selected the specific reason on page 2 of this application(see next page),AND Plan Review is NOT required because I meet all of the following sub sections that do not See Page 2 require Plan Review. ARE YOU AN OWNER PERFORMING WORK AS THE CONTRACTOR WITHOUT ELECTRICAL LICENSURE: ENO EYES-See Below& Pg,3 I 1 Pursuant to RCW 19.28.261,property owners and leaseholders cannot perform electrical work on buildings for rent,sale,or lease I without the proper electrical licensing and certficetion, or exemption. By checking this box, I am stating that I have completed and See Page 3 Signed the AFFIDAVIT on page 3 of this application to receive an exemption from this licensing/certification requirement. in '�° a R. ar. �. ' ' `8 ,k1"t. "4�ey ri•`�'rs<�F,1° Y^� qtr r Jr!: ,y�--4 .- ,- f..�. + •tt y !,�, yi �- ^�,'• :u ' • S g;{• '� � k S '1 r1,,A J �r i,, a� a"' OWNER NAME: TENANT BUSINESS NAME(If Commercial):iizuna Cider, IIC OWNER MAILING ADDRESS: STREET 909 SE EVERETT MALL WAY SPC A-124 crry EVERETT STATE WA „98208 OWNER PHONE:215-962.9230 OWNER EMAIL: CONTRACTOR NAME: EYLANDER SALES& SERVICE CONTRACTOR ADDRESS: sTREET3601 EVERETT AVE — Env EVERETT STATE WA ZIP 98201 CONTRACTOR PHONE:425-259.2161 CONTRACTOR EMAIL: CONTRACTOR LIC.#(REQUiREp)_EYLANSS142LP CITY OF EVERETT BUSINESS L1C.#(REQUIRED):01663 PRIMARY CONTACT: ❑OWNER ✓❑CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME:DA JOHN 1H N CONTACT PHONE:425.231.2275 CONTACT EMAIL: AGR MENT.:I hereby certify that I have read and examined this application and know the same to he 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 airy other state or 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! comply with the -to •ntractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only PERMIT#: .f J / s E I t) ." DF) Ow.:r/Authorized Agent Signature to (Devised 1/11/2019) Page 1-Application