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ELECTRICAL PERMIT APPLICATION <br /> 047TCITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257.8857 1(E)everetteps@everettwa.gov l waaw.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: 1402 Southeast Everett Mall Way Everett,WA'BUILDING AREA: 500 sq ft <br /> PROJECT TYPE: CJ NEW CONSTRUCTION El ADDITION m TENANT IMPROVMENT 0 REMODEL <br /> BUILDING USE: 0 SFR ❑TOWNHOUSE El DUPLEX 0 ADU 0 MULTI-FAMILY-#OF UNITS: 121 COMMERCl/ <br /> ELECTRICAL APPLICATION INFORMATION !, DESCRIPTION OF WORK <br /> CONTRACT PRICE OF WORK:$ 1700 ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIBE SCOPE OF WORK: <br /> Install 30 amp circuit and receptacle for new Hi Batch H oven <br /> THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE:(SELECT ALL THAT APPLY) <br /> LINE VOLTAGE WORK? ©NO ❑YES-Select Scope:0 Service 0 Feeder 0 Circuits-if:, _ 0 Complete Re-wire <br /> LOW VOLTAGE WORK? ®NO 0 YES-#of Devices: <br /> SELECT SCOPE(REQUIRED): El Data ❑Intercom 0 Thermostat 0 Audio 0 Secure Access 0 Security System <br /> ❑Fire Alarm-Installations under this permit only include electrical wiring rough-in of the system.An additic <br /> Fre Alarm Permit is required for review of device location and installation approval. <br /> ©other pat Ag):Installing a 30 amp dedicated appliance circuit <br /> CODE COMPLIANCE <br /> IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: O NO El YES--See Below&Pg.2 <br /> a By checking this box,I am stating that I have read and understand all of WAC 298-465-900,selected the specific reason on pegs <br /> of this application(see next page),AND Plan Review is NOT required because I meet all of the following sub sections that do not <br /> See Page 2 require Plan Review. <br /> ARE YOU AN OWNER PERFORMING WORK AS THE CONTRACTOR WITHOUT ELECTRICAL.LICENSURE:®NO OYES-See Below&P <br /> El Pursuant to RCW 1928.281,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 /> CONTACT INFORMATION <br /> OWNER NAME: Regal Cinemas Everett TENANT BUSINESS NAME(If Commercial): Regal Cinemas Everett <br /> OWNER MAIUNG ADDRESS: STREET 1402 Southeast Everett Mall Way <br /> arY Everett STATE WA ,98208 <br /> OWNER PHONE:844-462-7342 OWNER EMAIL: <br /> coNTRACToR NAME: Mastercraft Electric, Inc. <br /> CONTRACTOR ADDRESS: starer 206 Frontage Rd N <br /> CITY Pacific STATE WA zw 98047 <br /> CONTRACTOR PHONE:253-7374367 CONTRACTOR EMALL:kimd@mastercraftinc.com <br /> CONTRACTOR UC.#(REOUIRED):MASTEEI127B8 'CITY OF EVERETT BUSINESS UC./(REQUIRED):055704 <br /> PRIMARY CONTACT: DOWNER (}CONTRACTOR ['OTHER(Please Specify) <br /> CONTACT NAME: CONT089 <br /> ACT PHONE:206-295-0 <br /> K I M DARLING <br /> CONTACT EMAIL kimd@mastercrattinc.com <br /> AGREEMENT:!Newby certify that I hare reed and examined eppleation and know the same to be hue and carrot. All provisions cit laws and waferanoas governing rh <br /> type of work wi be completed whether specified herein or not. The granting of a permit does not presume to give authority to violate or carnet the provisions of any other st <br /> local krw ..• . •construction or the performance of construction. Thet I am autliortzed by the owner of this property to perform the work for which appacater,Is meds an <br /> cony*lath -" Comrades Law 18.27 RCW and 298.200 WAC. City of Everett Motel Use Only <br /> I / I PERMIT if <br /> +. V_ I 1/24/19 E 101 'D'P T I I <br /> Date (Rev seal Page 1-Aggiketi <br /> Scanned with CamScanner <br />