1604 BROADWAY EL GARCIA MARKET 2020-02-06

ELECTRICAL PERMIT APPLICA ON \✓ CITY OF EVERETT PERMIT SERVICES +M 1 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 (E)everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 1604 N Broadway Everett, WA 98201 BUILDING AREA: sq ft PROJECT TYPE: u NEW CONSTRUCTION ❑ADDITION TENANT IMPROVMENT ❑REMODEL BUILDING USE: ❑SFR ❑ TOWNHOUSE C] DUPLEX ❑ADU ❑MULTI-FAMILY-#OF UNITS: [71 COMMERCIAL ELECTRICAL APPLICATION INFORMATION & DESCRIPTION OF WORK,, ,_ .. t1 .b CONTRACT PRICE OF WORK:$ 2500 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: Reuse existing feeder, change out new disconnect switch for HVAC roof top unit. THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE:(SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ❑NO C'YES-Select Scope: Q Service ❑ Feeder 17 Circuits-#:2 ❑Complete Re-wire LOW VOLTAGE WORK? Q NO D YES-#of Devices:---- SELECT SCOPE(REQUIRED): ❑Data El intercom El Thermostat ❑Audio ❑ Secure Access ❑Security System Q 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. El Other(List All):HVAC-reuse existing circuit CODE COMPLIANCE.=' IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: la NO I YES--See Below&Pg.2 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 1I 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: LINO DYES-See Below&Pg.3 Pursuant to RCW 19.28.261,property owners and leaseholders cannot perform electrical work on buildings for rent,sale,or lease without the proper electrical licensing and certification,or exemption.By checking this box. I am stating that 1 have completed and See Page 3 signed the AFFIDAVIT on page 3 of this application to receive an exemption from this licensing/certification requirement. • OWNER NAME: TENANT BUSINESS NAME(If Commercial): El Garcia OWNER MAILING ADDRESS: STREET 1604 N Broadway car, Everett STATE WA ZIP 98201 OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: AC Electric Service, Inc. CONTRACTOR ADDRESS: STREET 804 W Meeker Street Suite 102 cm' Kent sTA1-F WA ,p 98032 CONTRACTOR PHONE:(253) 852-0225 [CONTRACTOR EMAIL:ac.elec@hotmail.com CONTRACTOR LIC.#(REQUIRED):ACELES1025DR JCITY OF EVERETT BUSINESS LIC.#(REQUIRED): 054204 PRIMARY CONTACT: ❑OWNER ,CONTRACTOR DOTHER(Please Specify) CONTACT NAME: CONTACT PHONE:(252) 852-0225 Kevin Lew S CONTACT EMAIL:ac.elec@hotmail.com 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 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 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 comply with the State Contractors Law 18.27 RCW and 298.200 WAC. City of Everett Official Use Only PERMIT#: < � -, .� _ � E1 � b2rb�j� - 2/7/19 Owner/Authorized Agrit Signature Date (Revised 1/11/2019) Page 1-Application