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A t 0 IP- ill <br /> E CTRICAL PERMIT APPLI4ION <br /> ,/ CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps©everettwa.gov I www.everettwa.govlpermits <br /> FROJE T SITE IN T ON <br /> PROJECT ADDRESS: 3402 McDougal Ave, Everett WA 98201 BUILDING AREA: 1°0°Q sq ft <br /> PROJECT TYPE: ❑NEW CONSTRUCTION D ADDITION 0 TENANT IMPROVMENT 0 REMODEL <br /> BUILDING USE: D SFR D TOWNHOUSE ❑DUPLEX ❑ADU __D MULTI-FAMILY-#OF UNITS: El COMMERCIAL <br /> ,,ELECTRICAL:APPLICA ION°:INFORMATION Si"DESCRIPTI N OF WORK <br /> CONTRACT PRICE OF WORK:$ 4160 ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIBE SCOPE OF WORK: <br /> Job#832256. DDC Low voltage controls for (1) RTU <br /> THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) <br /> ..,m, <br /> LINE VOLTAGE.WORK? ONO DYES-.Select Scope:0 Service ❑Feeder <br /> D Circuits-#: D Complete Re-wire <br /> LOW VOLTAGE WORK? D NO 0 YES-#of Devices:2 <br /> SELECT SCOPE(REQUIRED): 0 Data 0 Intercom ID Thermostat D Audio D Secure Access 0 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 /> D Other(List All): <br /> CODE COMPLIANCE.. . <br /> IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: t2 NO SI YES—See Below&Pg.2 <br /> D 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: Ei NO 'BYES-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 /> C's N` ACTINFORM • ION , . 1 <br /> OWNER NAME; Snohomish County TENANT BUSINESS NAME f Commercial): McDougal Shop <br /> . <br /> OWNER MAILING ADDRESS: STREET 3000 Rockefeller Ave <br /> cure Everett STATE WA z 98201 <br /> OWNER PHONE:425-388-6060 OWNER EMAIL:royscalf@snoco.org <br /> CONTRACTOR NAME: EC Company <br /> CONTRACTOR ADDRESS: sTREET981 Powell Ave SW <br /> cnY Renton STATE WA ZIP 98057 <br /> CONTRACTOR PHONE:206-242-3010 CONTRACTOR EMAIL:Charles.Myers@ecpowerslife.com <br /> CONTRACTOR LIC.#(REQUIRED):ECCOM~148BA CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 051774 <br /> PRIMARY CONTACT: DOWNER (]CONTRACTOR OTHER(Please Specify) <br /> _ w <br /> CONTACT NAME: CONTACT PHONE:206-412-3005 <br /> Charles Myers CONTACT EMAIL:Charles.Myers@ecpowerslife.com <br /> G` r 1 •reby ce .• that I ave reed and examined is app cation an• ow t e same to.:true and correct. All provisions o aws and. nances governing is <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 /> / �It E1� n2, -- <br /> Ow _. .a=,.,.a.,: A Signature Date (Revised 1/11/2019) Page 1-AppliiratIon <br />