701 E MUKILTEO BLVD FIRING RANGE 2020-01-30

• :� ELECTRICAL PER IT APDL TI©N � CITY OF EVERETT PERMIT SERVICES L. 3200 CEDAR STREET,EVERETT,WA 98201 T ' .. ;.. T. (P)425-257-8810 � FAX425-257-8�8m � 57I(E)ngeverettepsryryry��mgagap@everettwa.goq�v{�yy www.everettwa.gov/Permits �p PROJECT ADDRESS: 70/E Mil K 4'`7!o ,8,6 YTS, EV€R 8W (BUILDING AREA: sq ft PROJECT TYPE: ® NEW CONSTRUCTION ©ADDITION J TENANT IMPROVMENT ®REMODEL i-, •n r" .r411 COMMERCIAL BUILDING USE: it SFR • TOWNHOUSE 1 DUPLEX • ADU iU MULTI FAMILY #OF UNITS 'fflagiVARM ''.ELEC_nt- AL A P'aorptlrf N O?1A TION &y145crnPT N;OFWOR ..> ,.._...., . !CONTRACT PRICE OF WORK:$ 7 3O • 00 (ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: Po L/c E Y/A i va /e A'VG E LC,4D Duerr' Co/vPAI/✓,i1,✓f AND 1./1AA OvfinC,v1s A•00 4elP S"CRviG 4 „ . Ip . a P . • o. S .4 f[ ,. .. s so • E /c 4, / THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? 0 NO 1'.! YES-Select Scope: 'Irk Service 4 Feeder .Circuits-#:,__ / U Complete Re-wire LOW VOLTAGE WORK? eilt NO 0 YES-#of Devices: i SELECT SCOPE(REQUIRED): ®Data 0 Intercom 0 Thermostat QUI Audio '0 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. 0 Other(List All): //OO IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: NO U 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: ®NO EYES-See Below&Pg.3 rl Pursuant to RCW 19.28.261, property owners and leaseholders cannot perform electrical work on buildings for rent,sale,or lease 1-1 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. nonsaigignatEMNOWASSONOMPWORMAVOOMMENSNOWNWagaig OWNER NAME: Cr- OJ% E vgieg77 TENANT BUSINESS NAME(If Commercial): f°OL/CE f74l#4 RA MCE OWNER MAILING ADDRESS: STREET 70/ &fr1mA 12.1 0 d L✓P' C STATE �,Q , 0 3 CITY �IlE/E/ETr ZIP f8.2 ;' OWNER PHONE: 92 S• 7.3Y-aa 7 OWNER EMAIL: S Pta a/A• Et/xR eir t lr/,• 6.0v. NAME. c/ry of eVER E7T". SGd clOakef - 4oiv7-A4T -- - ADDRESS_: STREET 3/a) G.C-4 srifeevr CITGveot 4 STATE r _ / ZIP 9Q/p0 , 'CONTRACTOR PHONE:rZ S'751,,a.97 (CONTRACTOR EMAIL: $ / ' S a fs YER4 4441•CoV CONTRACTOR LIC.#(REQUIRED): ICITY OF EVERETT BUSINESS LIC.#(REQUIRED) PRIMARY CONTACT: ID~OWNER S 0 CONTRACTOR .MQTHER(Please Specify) YAG%/i 7!Apr E G G rie/G./ 4/ CONTACT NAME: CONTACT PHONE: yds.. 7rie 4'07 CONTACT EMAIL: ,SG p Trfl6c•�N,f .,r1+'I'G G/.V'S e E v'E/Q E.Ff` 1,!/i4 • GA AGREEMENT: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 C work of Efor whieht Opic licaatli n Use made e and I ccomply with the State Contractors Law 18.27 RCW and 296.200 WAC. PERMIT#: •wner/Authorized Age Si701P-. Date (Revised 1/11/2019) Page 1-Application