2000 HEWITT AVE EVERETT EVENT CENTER 2019-11-14

E CTRICAL PERMIT APPLI- TION CITY OF EVERETT PERMIT SERVICE= y- 3200 CEDAR STREET, EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps@everettwa.gov I www.everettwa.gov/permits :-..:4,- ,,PROJECT SITE INFORMATION PROJECT ADDRESS: 2000 Hewett Ave #115 BUILDING AREA: 100 sq ft PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ADDITION ✓❑ TENANT IMPROVMENT ❑ REMODEL BUILDING USE: ❑ SFR ❑TOWNHOUSE ❑ DUPLEX ❑ADU ❑ MULTI-FAMILY-#OF UNITS: ❑✓ COMMERCIAL ELECTRICAL APPLICATION INFORMATION,14:pgsquirriotcot WORK CONTRACT PRICE OF WORK: $ 2500 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: Install new circuits and receptacles for washer and dryer THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ❑ NO ❑✓ YES-Select Scope: ❑ Service ❑ Feeder ❑✓ Circuits-#.2 ❑ Complete Re-wire LOW VOLTAGE WORK? ❑ NO ❑YES-#of Devices: SELECT SCOPE (REQUIRED): ❑ Data ❑ Intercom ❑Thermostat ❑Audio ❑ 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): • COIEIIwFR IS THIS PERMIT EDUCATION, INSTITUTIONAL, HEALTH AND/OR PERSONAL CARE FACILITIES: ✓ NO LI YES--See Below&Pg. 2 I I 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 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 YOUAN OWNER PERFORMING WORK AS THE CONTRACTOR WITHOUT ELECTRICAL LICENSURE: ❑NO EYES-See Below&Pg. 3 n 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 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. CCINTA; I" OWNER NAME: City Of Everett TENANT BUSINESS NAME(If Commercial): Sports Performance Center OWNER MAILING ADDRESS: STREET Pd L OC- i J, V CITY STATE ZIP OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: Astor Electric CONTRACTOR ADDRESS: STREET 13228 SE 30th St C3 CITY Bellevue STATE v Y`/�, A zip 98005 CONTRACTOR PHONE:425-256-2988 CONTRACTOR EMAIL:derekl@astorelectric.com CONTRACTOR LIC.#(REQUIRED):ASTOREL931BU CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 046503 PRIMARY CONTACT: ❑OWNER ❑✓CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:425-864-5182 Derek Little CONTACT EMAIL:derekl@astorelectric.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 296.200 WAC. City of Everett Official Use Only PERMIT#: Digitally signed by Derek Little DN CoE,ctriccom, O Astr Electric,CN=Derek Little Date;2019.03.20100608-07'00' 3/20/19 \3 J Owner/Authorized Agent Signature Date (Revised 1/11/2019) Page 1-Application