6101 ASSOCIATED BLVD CORT PARTY RENTALS 2020-01-21

ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps@everettwagov I vvww.everettwagov/pertnits 4intriiMP-01:Wth itZtaqVgaiga4 , IPP PROJECT ADDRESS: 6101 Associated Blvd. - Suite#102 BUILDING AREA: sq ft PROJECT TYPE: CI NEW CONSTRUCTION 0 ADDITION 0 TENANT IMPROVMENT 0 REMODEL BUILDING USE: 0 SFR El TOWNHOUSE 0 DUPLEX ADU 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL VAlgictq 6..k WOK S 1144:4Nt„aratA'k?,. CONTRACT PRICE OF WORK:$ 11,750 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: Addition of(2)208V Ice Machine circuits, (2) 120V circuits for warehouse cord drops, relocate (2) 120V warehouse cord drops. THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE:(SELECT ALL THAT APPLY) LINE VOLTAGE WORK? 0 NO [Z]YES-Select Scope:0 Service 0 Feeder 0 Circuits-#:4 El Complete Re-wire LOW VOLTAGE WORK? 0 NO El YES-#of Devices: SELECT SCOPE(REQUIRED): 0 Data 0 Intercom 0 Thermostat 0 Audio El Secure Access 0 Security System 0 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): •„*104011Sf:i•AW:04,P1';;;V'r4A!!..001110404A 4,13.1(0 404?1: 1,44iste0tVitttitt44V giMhEiV,157 IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: 51 NO IIII YES--See Below&Pg.2 f — By checking this box,I am stating that I have read and understand all of WAC 296-4613-900,selected the specific reason on page 2 I 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:ONO 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 I have completed and See page 3 signed the AFFIDAVIT on page 3 of this application to receive en exemption from this licensing/certification requirement. Zi317,447,05VIN'sjirii OWNER NAME: TENANT BUSINESS NAME(if Commercial): CORT Party Rental OWNER MAILING ADDRESS: STREET 6101 Associated Blvd. Suite#102 Everett STATE WA zip 98203 OWNER PHONE:425-493-6969 OWNER EMAIL:Phil.heidt@cort.com CONTRACTOR NAME: Clinton&Sons Electric, Inc. CONTRACTOR ADDRESS: STREET 13515 SE 26th Street ow Bellevue STATE WA ZIP 98005 CONTRACTOR PHONE:425-746-7553 CONTRACTOR EMAIL:max@olintonandsons.com CONTRACTOR LIC.#(REQUIRED):CLINTSE177CM CITY OF EVERETT BUSINESS LIC.#(REQUIRED):054297 PRIMARY CONTACT: DOWNER DCONTRACTOR DOTHER(Please Specify) CONTACT NAME: CONTACT PHONE:425-864-9094 Max Clinton CONTACT EMAIL:max@olintonandsons.com AoRaaiwan-:I hereby certify that 1 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! comply with the State Contractors Law 18.27 RCW and 296.200 WAG. City of Everett Official Use Only PERMIT#: (Ale' /5 19 E \903 Owner/Aid riaki Agent Signature Date (Revised 1/1112019) Page 1-Application