7431 EVERGREEN WAY TACO BELL 2020-02-07

�N EttCTRICAL PERMIT APPLIC TION EVERETT 32CITY OF EVERETT PERMIT SERVICES 00 CEDAR STREET,EVERETT,WA 98201 WASHINGTON (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I wvvvv.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 7431 Evergreen Way BUILDING AREA: sq ft PROJECT TYPE: El NEW CONSTRUCTION El ADDITION El TENANT IMPROVMENT ❑ REMODEL BUILDING USE: El SFR ❑TOWNHOUSE ❑DUPLEX El ADU ❑MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL ELECTRICAL APPLICATION INFORMATION & DESCRIPTION OF WORK CONTRACT PRICE OF WORK:$ 1-1-0b,,9 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: Adding dedicated circuit for self ordering kiosk. THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ❑ NO [ YES-Select Scope: ❑ Service El Feeder 'Circuits-#: / ❑Complete Re-wire LOW VOLTAGE WORK? ❑ NO ❑YES-#of Devices: SELECT SCOPE(REQUIRED): El Data IJ Intercom ❑Thermostat ❑Audio LJ Secure Access LJ 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): CODE COMPLIANCE >. 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 296-46B-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 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 INFORMATION OWNER NAME: TENANT BUSINESS NAME(If Commercial):Taco Bell OWNER MAILING ADDRESS: STREET CITY STATE ZIP OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: Varsity Electric CONTRACTOR ADDRESS: STREETPO BOX 5336 CnY Lacey STATE WA ZIP 98509 CONTRACTOR PHONE:360-218-41 11 CONTRACTOR EMAIL:ryan@VarlStyeleCtnC.COm CONTRACTOR LIC.#(REQUIRED):VARSIEL833JJ CITY OF EVERETT BUSINESS LIC.#(REQUIRED): IteeA PRIMARY CONTACT: DOWNER QCONTRACTOR EITHER(Please Specify) CONTACT NAME: CONTACT PHONE:360 999-7917 Ryan Diaz CONTACT EMAIL:ryan@varsityelectric.com AGREEMENT:I hereby certify that t 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 t comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only PERMIT#: /b 3o /06/ E 10 D" 2:2)L, � i 9n.' - if�A'p oriz:. .- Date 7Ravracu 1/11/2C19)-- _""' rage fwppiicaliron "" 3