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<br /> LLECTRICAL PERMIT APPLCITION
<br /> L
<br /> EVERETT CITY OF EVERETT PERMIT SERVICES
<br /> 3200 CEDAR STREET,EVERETT,WA 98201
<br /> WASHINGTON (P)425-257-8810 I FAX 425-257-8857 I(E)everettepseeverettwa.gov I www.everetlwa.gov/permits
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<br /> PROJECT ADDRESS: 834 80th St SW BUILDING AREA: sq ft
<br /> PROJECT TYPE: 0 NEW CONSTRUCTION ©ADDITION El TENANT IMPROVMENT 0 REMODEL
<br /> BUILDING USE: 0 SFR ❑TOWNHOUSE 0DUPLEX 0 ADU 0 MULTI-FAMILY-#OF UNITS: 2 COMMERCIAL
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<br /> CONTRACT PRICE OF WORK:$ 7,522.00 ASSOCIATED BUILDING PERMIT#(if applicable):
<br /> DESCRIBE SCOPE OF WORK:
<br /> Provide & install 480 Volt 3 phase power tp accommodate a new overhead crane. 120V single phase
<br /> power &480V 3 phase new test bench. Add 120V receptacles east wall, add 30A of 480V to forklift
<br /> battery charger & duplex receptacle near roll up door. 3-way switching in warehouse.
<br /> THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE:(SELECT ALL THAT APPLY)
<br /> UNE VOLTAGE WORK? Q NO 0 YES-Select Scope: ❑Service 0 Feeder ❑Circuits-#: 0 Complete Re-wire
<br /> LOW VOLTAGE WORK? 2 NO ❑YES-#of Devices:
<br /> SELECT SCOPE(REQUIRED): El Data 0 Intercom 0 Thermostat 0 Audio ❑Secure Access ❑Security System
<br /> El Fire Alarm-Installations under this permit only include electrical wiring rough-in of the system.An additional
<br /> Fire Alarm Permit is required for review of device location and installation approval.
<br /> � ❑Other(List All):
<br /> , 4}}!2.7 ,":f* 'k'AllriPte11.?. . yr . .
<br /> CF'" „";N
<br /> IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: 21 NO 0 YES-W See Below&Pg.2
<br /> By checking this box,I am stating that I have read and understand all of WAC 29646B-900,selected the specific reason on page 2
<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:ONO DYES-See Below&Pg.3
<br /> '—'-" Pursuant to RCW 19,28.261,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,1 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 /> rASIRMAIRCI4t'Mfi .��,���f..r- ,
<br /> OWNER NAME: TENANT BUSINESS NAME(If Commercial):Unit Process Co
<br /> OWNER MAILING ADDRESS: matter 834 80th ST SW ryr�
<br /> cry Everett STATE WA 2IP 98203
<br /> OWNER PHONE:425-438-8726 OWNER EMAIL:imckelvie@unitprocess.com
<br /> com
<br /> CONTRACTOR NAME: Precision Electric Group Inc
<br /> CONTRACTOR ADDRESS: STREET I5323 NE 90th Street
<br /> cny Redmond STATE WA zip 98052
<br /> CONTRACTOR PHONE:206-948-9805 CONTRACTOR EMAIL:terryd@pegiinc.com
<br /> CONTRACTOR LIC.#(REQUIRED):PRECIEG969PH CITY OF EVERETT BUSINESS UC.#(REQUIRED):047780
<br /> PRIMARY CONTACT: DOWNER ❑CONTRACTOR QOTHER(Please Specify) Tenant
<br /> CONTACT NAME: CONTACT PHONE:425-438.8726
<br /> John McKelvie
<br /> CONTACT EMAEL:jmakelvie@unitprOGesS.Com
<br /> 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
<br /> 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
<br /> 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
<br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only
<br /> PERMIT#:
<br /> t '} 111712019 lb
<br /> Owner/Authorized Agent Signature DateR� 1/11/2019)
<br /> Date (Revised Page 1—Application
<br />
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