6502 EVERGREEN WAY FIT BODY BOOT CAMP 2020-02-07

OPECTRICAL PERMIT APPLITION ��' CITY OF EVERETT PERMIT SERVICES !^ 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 1 FAX 425-257-8857 1(E)everetteps©everettwa.gov 1 www.everettwa.gov/permits PRO. ECT SITEINFORMATILt'N PROJECT ADDRESS: 6502 Evergreen Way BUILDING AREA: 3078 sq ft PROJECT TYPE: ❑NEW CONSTRUCTION 0 ADDITION El TENANT IMPROVMENT ❑ REMODEL BUILDING USE: ❑SFR El TOWNHOUSE El DUPLEX El ADU ❑ MULTI-FAMILY-#OF UNITS: CI COMMERCIAL ELECTRICAL APPLICATION,INFORMATION&DESCRIPTION:OF WORK CONTRACT PRICE OF WORK:$ 50,000 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: Install power and lighting; connections to new heat source; connection to new water heater; new 200a service THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? El NO El YES-Select Scope:El Service El Feeder l Circuits-#:15 ❑Complete Re-wire LOW VOLTAGE WORK? El NO El YES-#of Devices:8 SELECT SCOPE(REQUIRED): El Data El Intercom ❑Thermostat ❑Audio ❑ Secure Access El Security System C1 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 Ct MPLIlANCE, IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: NO El YES--See Below&Pg.2 I1-1 I 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 r 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 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 INFORMATION OWNER NAME: J.T. Madison Inc. TENANT BUSINESS NAME(If Commercial):Fit Body OWNER MAILING ADDRESS: STREET PO Box 31609 cm( Seattle STATE WA zip 98103 OWNER PHONE:206-619-5555 OWNER EMAIL:toddmadison@hotmail.com CONTRACTOR NAME: Sterling Electrical Constractors CONTRACTOR ADDRESS: sTREET6925 216th St SW, Suite K cnv Lynnwood STATE WA zip 98036 CONTRACTOR PHONE:425-774-1903 CONTRACTOR EMAIL: estimates@secseattle.com its # Tp CONTRACTOR LIC.#(REQUIRED):STERLEC859MS CITY OF EVERETT BUSINESS LIC.#(REQUIRED):ookt000000cism000000 PRIMARY CONTACT: EI OWNER E✓CONTRACTOR DOTHER(Please Specify) CONTACT NAME: CONTACT PHONE:425-774-1903 Aaron Graves CONTACT EMAIL:aaron@secseattle.com 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 PERMIT#:Qn 3/14/201915 E L-t,U3 —oqj Owner/A tzed Agent Signature Date (Revised 1/11/2019) (igel.:71,