1707 MERRILL CREEK PKY 2020-01-30

04/22/2019 20 : 32 #4160 P. 001/003 ELECTRICAL PERMIT APPLICATION E V E R E T TCITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 WASHINCITON (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps®everettwa.gov I '. "�, • �• ww i.everetta,�..gov/per� its `;( ' : ;e�• 'rd7 a, r d " � w PROJECT ADDRESS. 1707 MERRILL CREEK PARKWY BUILDING AREA: sq ft PROJECT TYPE: ❑ NEW CONSTRUCTION El ADDITION El TENANT IMPROVMENT ❑ REMODEL BUILDING USE: ❑SFR El TOWNHOUSE ❑ DUPLEX LI ADU 1=1 MULTI-FAMILY-#OF UNITS:90bs 2 COMMERCIAL • �� , �•• i , , 77cI.` -17�. 77'6 'L _ adv�. .._.... , ,..^ 7Y 3 CONTRACT PRICE OF WORK:$ 1000 ASSOCIATED BUILDING PERMIT#(If applicable): DESCRIBE SCOPE OF WORK: NEW DISCONNECT FOR REPLACEMENT TRASH COMPACTOR. THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ❑ NO O YES-Select Scope; El Service 0 Feeder ❑ Circuits-#:1 ❑Complete Re-wire LOW VOLTAGE WORK? Q NO ❑YES-#of Devices: SELECT SCOPE(REQUIRFR): ❑ Data ❑ Intercom ❑Thermostat ❑Audio ❑Secure Access El Security System El 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. �/r ❑Other• y (List All): 'g �'�il�?'.JS ":r1' •`'Jc q„iR�..![,*"°"{'i C y'�..V. yr Y�•f°+t'.�:.'C t ' Ir�'N % gyp'rt •� �w'+tn^Pa;2, 1trwLi Y- S " i,� Jar • J.x., IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: ENO El YES—See Below&Pg.2 nII By checking this box,I am stating that I have read and understand all of WAG 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: ONO EYES-See Below&Pg.3 E 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 liicensing/certification requirement. 41' ,4C t, ” ; 'Sipr ry M,£M. . , k`7i HSti ZW.,W a iN 1 OWNER NAME: GREENS OF MERRILL CREEK TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: ST1 ET 1707 MERRILL CREEK PARKWAY cm' STATE ZIP OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: EYLANDER SALES Sr SERVICE CONTRACTOR ADDRESS: 511 EET3601 EVERETT AVE ciry EVERETT STATh WA Zip 98201 CONTRACTOR PHONE:425-259.2161 !CONTRACTOR EMAIL: CONTRACTOR LIC-#(REQuIRED):EYLANSS142LP CITY OF EVERETT BUSINESS LIC.#(REQUIRED):016363 PRIMARY CONTACT: ❑OWNER ]CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: C EYLA N Q CONTACT PHONE:425.231.2275 J CONTACT EMAIL:jceyIarider@yaho0.001T1 A'iREEMENT /hereby certify that I have read and elernined this application and know the same to be true end 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 Of local law regulating .nstroction 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 t j.:to Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only 'I5ERMIT#: je Ow : /Authorized Agent Signature Da (Revised 1/11/2019) Page 1•Appiication