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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 (E)everelleps@everettwa.gov www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: 1315 Pacific Ave, Everett, WA 98201 BUILDING AREA: sq ft <br /> PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ADDITION ❑TENANT IMPROVMENT ✓❑ REMODEL <br /> BUILDING USE: ❑SFR El TOWNHOUSE El DUPLEX ❑ADU 0 MULTI-FAMILY-#OF UNITS: ❑ COMMERCIAL <br /> ELECTRICAL APPLICATION INFORMATION & DESCRIPTION OF WORK' <br /> CONTRACT PRICE OF WORK:$ 12000 ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIBE SCOPE OF WORK: <br /> Conversion of open access area's to LED retrofit <br /> THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) <br /> LINE VOLTAGE WORK? ❑ NO ❑✓ YES-Select Scope: ❑✓ Service ❑ Feeder ❑Circuits-#: El Complete Re-wire <br /> LOW VOLTAGE WORK? ❑✓ NO ❑YES-#of Devices: <br /> SELECT SCOPE(REQUIRED): ❑ Data El Intercom ❑Thermostat E Audio ❑Secure Access ❑ Security System <br /> ❑ Fire Alarm-Installations under this permit only include electrical wiring rough-in of the system.An additional <br /> Fire Alarm Permit is required for review of device location and installation approval. <br /> ❑ Other(List All): <br /> CODE COMPLIANCE <br /> IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: ✓n NO n YES--See Below&Pg. 2 <br /> By checking this box,I am stating that I have read and understand all of WAC 296-46B-900,selected the specific reason on page 2 <br /> of this application(see next page),AND Plan Review is NOT required because I meet all of the following sub sections that do not <br /> See Page 2 require Plan Review. <br /> ARE YOU AN OWNER PERFORMING WORK AS THE CONTRACTOR WITHOUT ELECTRICAL LICENSURE: ❑✓NO DYES-See Below&Pg. 3 <br /> ✓ Pursuant to RCW 19.28.261,property owners and leaseholders cannot perform electrical work on buildings for rent,sale,or lease <br /> without the proper electrical licensing and certification,or exemption. By checking this box, I am stating that I have completed and <br /> See Page 3 signed the AFFIDAVIT on page 3 of this application to receive an exemption from this licensing/certification requirement. <br /> CONTACT INFORMATION <br /> OWNER NAME: Greystar (Chris Polley) TENANT BUSINESS NAME(If Commercial):Lumen Apartments <br /> OWNER MAILING ADDRESS: STREET 701 Pike St. Seattle <br /> CITY Seattle STATE WA Z,P 98101 <br /> OWNER PHONE:206.366.5268 OWNER EMAIL:cp011ey@greystar.Com <br /> CONTRACTOR NAME: Resound Energy <br /> CONTRACTOR ADDRESS: STREET22122 20th Ave SE Unit 159 <br /> CITY Bothell STATE WA ZIP 98021 <br /> CONTRACTOR PHONE:2069054332 CONTRACTOR EMAIL:Warrenb@resoundenergy.com <br /> CONTRACTOR LIC.#(REQUIRED):RESOUEL861 N6 CITY OF EVERETT BUSINESS LIC.#(REQUIRED);58285 <br /> PRIMARY CONTACT: DOWNER ❑✓CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:2069487739 <br /> Jessica Bechtel CONTACT EMAIL:jessicab@resoundenergy.com <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 and ordinances 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 City of Everett Official Use Only <br /> PERMIT#: <br /> Jessica Bechtel 4/2/2019 E M. D140 <br /> Owner/Authorized Agent Signature Date (Revised 1/11/2019) Page 1-Application <br />