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Ine <br /> ELECTRICAL PERMIT APPLICATION <br /> EVERETT CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> WASHINGTON (P)425-257-8810 1 FAX 425-257-8857 1 (E)overetteps@everettwa.gov 1 www.everettwa.gov/permits <br /> PRO.1e,S_+T'*Ii E INFER Ti11N4 • - <br /> PROJECT ADDRESS: 2934 Panaview Blvd BUILDING AREA: sq ft <br /> PROJECT TYPE: LI NEW CONSTRUCTION ❑ADDITION ❑TENANT IMPROVMENT ✓❑ REMODEL <br /> BUILDING USE: ✓❑SFR ❑ TOWNHOUSE ❑ DUPLEX ❑ADU ❑ MULTI-FAMILY-#OF UNITS: ❑ COMMERCIAL <br /> ELL T"R CAL+'APP I A lON4 .1 f.MAt , !,41b*ScRIP IOW OF°WOR1 <br /> CONTRACT PRICE OF WORK:$ 7000 ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIBE SCOPE OF WORK: <br /> Install 12KW Kohler Generator <br /> Install 100 Amp ATS with load management <br /> THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) <br /> LINE VOLTAGE WORK? ❑ NO ❑YES-Select Scope: 11 Service ❑ Feeder ❑Circuits-#: ❑ Complete Re-wire <br /> LOW VOLTAGE WORK? ❑ NO ❑ YES-#of Devices: <br /> SELECT SCOPE(REQUIRED): ❑ Data ❑ Intercom ❑Thermostat ❑Audio ❑ Secure Access ❑ 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 /> ❑Other(List All): <br /> IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH ANDIOR PERSONAL CARE FACILITIES: ❑ NO El YES--See Below&Pg.2 <br /> n 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 dc not <br /> See Page 2 require Plan Review. <br /> ARE YOUAN OWNER PERFORMING WORK AS THE CONTRACTOR WITHOUT ELECTRICAL LICENSURE: ONO EYES-See Below&Pg.3 <br /> l l 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 /> OWNER NAME: Cheryl Mercer TENANT BUSINESS NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 2934 Panaview Blvd <br /> cm, EVERETT STATE WA zip 98203 <br /> OWNER PHONE: 425-319-0179 OWNER EMAIL: cherylmercer@comcast.net <br /> CONTRACTOR NAME: PARKER BROS ELECTRIC <br /> CONTRACTOR ADDRESS: STREET 13630 54TH DR NE <br /> cin. MARYSVILLE STATE WA I,,, 98271 <br /> CONTRACTOR PHONE:425-239-6319 CONTRACTOR EMAIL: admin@parkerbroselectric.com <br /> CONTRACTOR LIC.#(REQUIRED): PARKEBE845NT CITY OF EVERETT BUSINESS LIC.#(REQUIRED):56709 <br /> PRIMARY CONTACT: ['OWNER ['CONTRACTOR ✓❑OTHER(Please Specify) OFFICE ADMIN <br /> CONTACT NAME: CONTACT PHONE:360-572-0108 <br /> Natalie CONTACT EMAIL: admin@parkerbroselectric.com <br /> AGREEMENT:1 hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this <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 l 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#: ( 0 5 <br /> I 12/1012019 E ��`2, '� <br /> Own rlAuthorized gent S gnature Date (Revised 1/11/2019) Page 1-Application <br />