332 SW EVERETT MALL WAY NATIONAL GENERAL INSURANCE 2020-02-07

1W ELECTRICAL PERMIT APPLICATION EVERETT CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 WASHINGTON (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE,.INFOEIVIATI iN PROJECT ADDRESS: 332 SW?Everett Mall Way BUILDING AREA: sq ft PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ADDITION ❑TENANT IMPROVMENT ✓❑ REMODEL BUILDING USE: ❑SFR ❑ �.14VN USE ❑ DUPLEX ❑ADU ❑ MULTI-FAMILY-#OF UNITS: ✓❑COMMERCIAL `' EIS:, PPI ICAtION INFORM TION &.::DESCRIPTI ON �WO CONTRACT PRICE OF W . $ 4,552 C/ ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF W RK: Install power and da on d floor. Install surface mounted power and data on 4th floor. Install power and data over floor raceway. THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ❑ NO ❑✓ YES-Select Scope: ❑ Service ❑ Feeder ❑ Circuits-#:3 ❑ Complete Re-wire LOW VOLTAGE WORK? ❑ NO ❑✓ YES-#of Devices:6 SELECT SCOPE(REQUIRED): ❑ Data ❑ Intercom ❑Thermostat ❑Audio El Secure Access ❑ Security System El 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): ` CODE COMPLIANCI .....L . , � IS THIS PERMIT EDUCATION, INSTITUTIONAL, HEALTH AND/OR PERSONAL CARE FACILITIES: L✓� NO n 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: ONO DYES-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. 1,' : 'CONTACT INFORMWA, �.�... t !,,a OWNER NAME: Newmak Knight Frank Mgt TENANT BUSINESS NAME(If Commercial): National General Insurance OWNER MAILING ADDRESS: STREET 760 SE 9th Ave, Suite 200 CITY Portland STATE WA ZIP 97205 OWNER PHONE:425-948-1480 OWNER EMAIL: CONTRACTOR NAME: Titan Electric CONTRACTOR ADDRESS: STREET 12828 Northup Way, Suite 205 CITY Bellevue STATE WA ZIP 98005 CONTRACTOR PHONE:206.633.2811 CONTRACTOR EMAIL:Permits@titanelectric.net CONTRACTOR LIC.#(REQUIRED):TITANE196308 CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 51191 PRIMARY CONTACT: DOWNER ❑✓CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:206.633.2811 Jon Osborne CONTACT EMAIL:permits@titanelectric.net AGREEMENT I 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 .,gi;9lldlly signed by Linda Anderson PERMIT#: AN C=US,E=lintlaa�titanelearic.net, �rLinda Anderson son ectrcCompanylnCN=Lntla VC\ Date'2019.06.28 07:25:13-07'00' Owner/Authorized Agent Signature Date (Revised 1/11/2019) Page 1-Application