3927 RUCKER AVE BASE FILE 2020-01-30

ELECTRICAL PERMIT APPLICATION -11 CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257=8857 1(E)everetteps@everettwa.gov( www.everetfwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 3927 Rucker Ave, Everett WA 98201 BUILDING AREA(If residential,new construction,remodel,or addition)5000 SF BUILDING TYPE 0 SFR-DETACHED 0 SFR-ATTACHED ❑DUPLEX ❑MULTI-FAMILY #OF UNITS: 0 COMMERCIAL USE.OF BUILDING: Medical ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK:$ 4800 NUMBER OF DEVICES(if low voltage): FIRE ALARM? 0 YES 0 NO ASSOCIATED BUILDING PERMIT#(9f applicable): DESCRIPTION OF WORK: Disconnect and reconnect of existing line and low voltage for_I RTU.This scope does not increase the current load by more than 5%. f97 61,- CONTACT CONTACT INFOR TION OWNER NAME:The Everett Clinic TENANT NAME If Commercial;The Everett Clinic OWNER MAILING ADDRESS: s7REET 3901 Hoyt Ave c,Ty Everett STATE WA zip 98201 OWNER PHONE: 425-258-3900 [OWNER EMAIL CONTRACTOR NAME; EC Company CONTRACTOR ADDRESS: smREEr 6412 S 196th St CITY Kent STATE WA zip 98032 CONTRACTOR PHONE 206-242-3010 CONTRACTOR EMAIL Charles.Myers@ecpowerslife.com CONTRACTOR LIC. REQUIRED• ECCOM**148BA !TY OF EVERETT BUSINESS LIC REQUIRED;051774 PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR 0 OTHER(Please Specify); CONTACT NAME: CONTACT PHONE 206-412-3005 Charles Myers CONTACT EMAIL;Charres.Myers©a ec owerslife.com 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 l am authorized by the owner of this property to perform the work for which application is made and I comply with the State Contrectors Law 18.27 RCW and 286.200 WAC. City of Everett Official Use Only M .. PERMIT# •. t,, ,$-prized ent Signature Date (Revised 9/23/2018)