Laserfiche WebLink
=CTRICAL PERMIT APPLI R11ON 0I•?' <br /> 047CITY OF EVERETT PERMIT SERVICES <br /> C) COgiCZKot-1^ <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 i(E)evereiteps(d everettwa.gov I www.everettwa.govipennits <br /> : "s4 t <br /> PROJECT ADDRESS: t 1 _( 'F <br /> L�`t mac.- �J[11 I Q`� �(� t;�� i f,rs BUILDING AREA: sq ft <br /> PROJECT TYPE: 0 NEW CONSTRUCTION El ANION 0 TENANT IMPROVMENT 0 REMODEL <br /> BUILDING USE: 0 SFR 0 TOWNHOUSE 0 DUPLEX El ADU 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> ELECTRICAL 1 ,PPI IcATIO,N.TiNFORMATICtl; >'&DESPAI ' ON,OF"WORK <br /> CONTRACT PRICE OF WORK:$ I }2"t'ca.) <br /> ASSOCIATED BUILDING PERMIT#(If applicable): <br /> DESCRIBE SCOPE OF WORK: - . - <br /> THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) <br /> LINE VOLTAGE WORK? ❑,,"NNO 0 YES-Select Scope: Wserviceeeder 0 Circuits-#: O Complete Re-wire <br /> LOW VOLTAGE WORK? L9O 0 YES-#of Devices: <br /> • SELECT SCOPE(REQUIRED): El Data El Intercom 0 Thermostat 0 Audio 0 Secure Access 0 Security System <br /> 0 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 /> • <br /> 0 Other(List All): <br /> 4. .. • .., ...w k.:.{. 4. q,^t • a t ` 1 CODE COM IANC . ,.,.. . <br /> firs=THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: FA NO 0 YES--See Below&Pg.2 <br /> ay 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 <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 /> Sae Page 2 require Plan Review. <br /> ARE YOU AN OWNER PERFORMING WORK AS THE CONTRACTOR WITHOUT ELECTRICAL LICENSURE:ONO OYES-See Below&Pg.3 <br /> Pursuant to ROW 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,I am stating that I have completed and <br /> : ge Page 3 signed the AFFIDAVIT on page 3 of this application to receive an exemption from this licensing/certification requirement. <br /> • <br /> i.'v.•: .. . ON:;r <CI <br /> OWNER NAME: TENANT BUSINESS NAME(If Commercial): Boeing <br /> ';� <br /> ^? 1NER MAILING ADDRESS: STREET PO Box 3707 <br /> c,n Seattle STATE WA zip 98124-2207 <br /> Q•WNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: General Construction Company <br /> 6.ONTRACTOR ADDRESS: sTREET PO Box 46 �}�r R crry <br /> Mukilteo STATE WA z,, 98204 <br /> CONTRACTOR PHONE:426-294 '1944 CONTRACTOR EMAIL:Bridget Burns Cr,►kiewit.com <br /> CONTRACTOR LIC.#(REQUIRED):GENERCC984OZ CITY OF EVERETT BUSINESS LIG.#(REQUIRED):040599 <br /> n-,. Y BUSINESS I #(REQUIRED): <br /> PRIMARY CONTACT: DOWNER QCONTRACTOR 00THER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:206-7'30.6546 <br /> Dennis Crow CONTACT EMAIL:Dennis.crow awkiewit.com <br /> AGREEMENT:f hereby certify that I have read and examined this application end know the same to be true and corracl. All provisions of laws end ordinances governing this <br /> •type of work wits 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 step or <br /> local law regulating constmc!ion or the performance of construction. That lam authorized by the owner of this property to perform the work for which application Is made end I <br /> comply with the Slate Contractors Law 18.27 RCW end 298.200 WAC. City of Everett Official Use Only <br /> O PERMIT#: <br /> ilk. .4 ►� E .. • � E V\ \O — X22 <br /> 't*iA't •the.nrrrat Ignature Date (1,tkvised 1/1112019) Page 1-ApplicatIorn <br />