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ELECTRICAL PERMIT APPLitATION <br /> 44/-4 CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps@evereftwalinv www.everettwa.goviparmits <br /> PROJECT ADDRESS: 948 Woodlawn Ave, Everett WA 98203 BUILDING AREA: NA sq ft <br /> PROJECT TYPE: El NEW CONSTRUCTION LI ADDITION 0 TENANT IMPROVMENT 0 REMODEL <br /> BUILDING USE: LI SFR 0 TOWNHOUSE El DUPLEX 0 ADU MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> __ <br /> a AL APPLICA •190,' ON rR <br /> CONTRACT PRICE OF WORK:$ 2500 ASSOCIATED BUILDING PERMIT# applicable): <br /> DESCRIBE SCOPE OF WORK: Insta 20A Service on Pole T405013-77 fiii'Comcast Power <br /> Supply <br /> THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) <br /> LINE VOLTAGE VOLTAGE WORK? NO El YES-Select Scope: Service TI Feeder CI Circults-#: 0 Complete Re-wire <br /> LOW VOLTAGE WOR/ 7—NT-10 EiC;:#of Devices: <br /> SELECT SCOPE(REQUIRED): LI Data LI Intercom CI Thermostat 0 Audio 0 Secure Access 71 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 /> O Other(List All):_® <br /> C• 77-7 IP'1 1: ' ,N`4," <br /> IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: NO U YES—See Below&Pg.2 <br /> 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 <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 OWNER PERFORMING WORK AS THE CONTRACTOR WITHOUT ELECTRICAL LICENSURE: [ NO OYES-See Below&Pg.3 <br /> E 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, I am stating that I have complied:ad and <br /> see page 3 signed the AFFIDAVIT on page 3 of this application to receive an exemption from this licensing/certification requirement <br /> COlvrr 7.1 If <br /> OWNER Comcast TENANT BUSINESS NAME If Commercial <br /> ,OWNER MAILING ADDRESS: STREET 1525 75th St SW#200 <br /> crry Everett STATE WA ZIP 98203 <br /> OWNER PHONE: OWNER EMAIL:losephiordon@comcast.Com <br /> CONTRACTOR NAME: Ault Electric Services LLC <br /> CONTRACTOR ADDRESS: sTREET 2348 Holgate Street South <br /> CITY Tacoma STATE WA ZIP 98402 <br /> CONTRACTOR PHONE:(253)470-2858 CONTRACTOR EMAIL:Jeremyw@auftelectricservices.com —1 <br /> CONTRACTOR LIC.#(REQUIRED):AULTEES821LR CITY OF EVERETT BUSINESS UC.SkREcuiRED); <br /> PRIMARY CONTACT: LIOWNER [ CONTRACTOR OOTHER(Please Specify) <br /> CONTACT NAME!Jeremy Wilson CONTACT PHONE: (253) 606-0356 <br /> CONTACT EMAIL: jerem eaultelectricservices.com <br /> AGREEMENT.I hereby candy that I have read and examined this application and know the same to be true send comet 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 /> boat 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! <br /> comply with the State Contractors Lw 18.27 RCW end 286.200 WAC. City of Everett Official Use Only <br /> PERMIT#: <br /> I 1-ar 4 4/2019 <br /> E rc9oq -OSS <br /> • ri githorize Aunt nature Date (Revised 1/11/2019) Page 1-ApplicAti on <br />