3120 COLBY AVE 2020-02-06 - Laserfiche WebLink

cLECTRICAL PERMIT APPLICATION 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 I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 3120 colby ave (Suite 100), Everett,WA, 982 BUILDING AREA: 300 sq ft PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ ADDITION ❑TENANT IMPROVMENT 0 REMODEL BUILDING USE: ❑ SFR ❑ TOWNHOUSE ❑ DUPLEX ❑ADU ❑ MULTI-FAMILY-#OF UNITS: ❑✓ COMMERCIAL ELECT 1CA .AP -LICATIONIOMMATiONI & DESCRIPTION • CONTRACT PRICE OF WOW:$ 300 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: 120v 20amp circuit tc ce THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ❑ NO ❑YES-Select Scope: ❑ Service ❑ Feeder ❑✓ Circuits-#:1 ❑ Complete Re-wire LOW VOLTAGE WORK? ❑ NO ❑YES-#of Devices: SELECT SCOPE(REQUIRED): ❑ Data ❑ Intercom ❑Thermostat ❑Audio ❑ Secure Access ❑ Security System ❑ 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. ❑Other(List All): H �s OODkyC+O.. PLukNCE ,',. IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: ❑ NO n YES--See Below&Pg.2 By checking this box, I am stating that I have read and understand all of WAC 296-466-900,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. EYES YOU AN OWNER PERFORMING WORK AS THE CONTRACTOR WITHOUT ELECTRICAL LICENSURE: ENO EYES-See Below&Pg.3 — 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 licensing/certification requirement. CONTACT SO TI tN - :41144;W:' ,, OWNER NAME: TENANT BUSINESS NAME(If Commercial): National Title Company OWNER MAILING ADDRESS: STREET 3120 colby ave(Suite 100) cm Everett ��f STATE •A ZIP 98201 OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: EC Electric CONTRACTOR ADDRESS: STREET981 Powell Ave S, Suite 200 c,r Renton STATE WA ZIP 98057 CONTRACTOR PHONE:206-436.6070 CONTRACTOR EMAIL:drew.kinnison@ecpowerslife.com CONTRACTOR LIC.#(REQUIRED):EC ECCOM**148BA CITY OF EVERETT BUSINESS LIC.#(REQUIRED):051774 PRIMARY CONTACT: DOWNER ❑✓CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:206-771-3901 Drew CONTACT EMAIL:Orewkinnison@ecpowerslife.com AGREEMENT:/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 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 work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296,200 WAC. City of Everett Official Use Only PERMIT#: Owner/Authorize: •gent Signature Date (Revised 1/11/2019) Page 1-Application