9930 19TH AVE SE 2019-11-15 - Laserfiche WebLink

1477- ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 I(E)everettaps@everettwa,gev I www.everettwa.gov/permits - PROJECT SITE INFORMATION PROJECT ADDRESS: 9930 19TH AVE SE EVERETT, WA 98208 BUILDING AREA: sq ft PROJECT TYPE: 0 NEW CONSTRUCTION CI ADDITION El TENANT iMPROVMENT 0 REMODEL BUILDING USE: CI SFR [7]TOWNHOUSE El DUPLEX CI ADU El MULTI-FAMILY-#OF UNITS: 71 COMMERCIAL ELECTRICAL APPLICATION INIFORMATIONADESCRIPTIRK CONTRACT PRICE OF WORK:$ 21,200.00 ASSOCIATED BUILDING PERMIT#(if applicable): 9) — DESCRIBE SCOPE OF WORK: TENANT IMPROVEMENTS THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? 0 NO YES-Select Scope: El Service E FeedertiE Circuits-#'20 O Complete Re-wire LOW VOLTAGE WORK? El NO El YES-#of Devices: SELECT SCOPE(REQUIRED)- El Data [1 Intercom El Thermostat El Audio CI Secure Access El Security System CI 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): CODE COMPLIANCE IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: CI NO El 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 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 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. CONTACT INFORMATION OWNER NAME: ESI-EXPRESS TENANT BUSINESS NAME(If Commercial):WENDYS OWNER MAILING ADDRESS: s-REET 3330 E. LOUISE DR SUITE 300 cmr MERIDIAN STATE ID 2,, 83642 OWNER PHONE:206-362-3040 OWNER EMAIL: CONTRACTOR NAME: MERIDIAN CENTER ELECTRIC CONTRACTOR ADDRESS: STREET 11109 66TH AVE CiTv PUYALLUP STATE WA 7,, 98373 CONTRACTOR PHONE:360-4 19-0580 CONTRACTOR EMAIL:MTVPRODUCTION@MCELECTRIC.COM CONTRACTOR LIC.#(REQuiRED):MERIDCE318SG CITY OF EVERETT BUSINESS LIC.#(REQUIRED): ?).-) oLl PRIMARY CONTACT: DOWNER ECONTRACTOR [ ]OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:360-419-0580 AMANDA BYERS CONTACT EMAIL:MTVPRODUCTION@MC ELECTRIC.COM AGREEMENT:1 hereby certify that 1 have mad 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 stale or local taw regulating construction or the performance of construction. That 1 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 ROW and 296.200 WAC City of Everett Official Use Only PERMIT#: CliliViva4ZI(VA 192 g 1 E 3-Crzfi it Owner/Authorized Agent Signet r, Date (Revised 1/71/2019) Page I-Application