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1112 ZLECTRICAL PERMIT APPLILIATION <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)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: 8417 Evergreen way BUILDING AREA: 6,324 sq ft <br /> PROJECT TYPE: ✓❑ NEW CONSTRUCTION ❑ADDITION ❑ TENANT IMPROVMENT ❑ REMODEL <br /> BUILDING USE: ❑SFR ❑TOWNHOUSE ❑ DUPLEX ❑ADU ❑ MULTI-FAMILY-#OF UNITS: ❑✓ COMMERCIAL <br /> ELECTRICAL APPLICATION INFORMATION,& DESCRIPTION OF WO' ' . <br /> ASOCIATE <br /> CONTRACT PRICE OF WORK: $ 100,000 SD BUILDING PERMIT#(if applicable).V�-��(gO5, Ol <br /> DESCRIBE SCOPE OF WORK: �lJ <br /> Installation of new power feeders, service, parking lot and exterior lighting, signage power. Electrical panels for <br /> suite 1,2 and 3. Rough in for fire alarm. <br /> THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) <br /> LINE VOLTAGE WORK? ❑ NO ❑ YES-Select Scope: ❑ Service ❑ Feeder ❑ Circuits-#: ❑✓ Complete Re-wire <br /> LOW VOLTAGE WORK? ❑ NO ❑YES-#of Devices: <br /> SELECT SCOPE(REQUIRED). ❑ Data ❑ Intercom ❑Thermostat ❑Audio ❑ Secure Access ❑ Security System <br /> ✓❑ 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 /> G O MANCE" <br /> IS THIS PERMIT EDUCATION, INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: ✓❑ NO ❑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 AN OWNER PERFORMING WORK AS THE CONTRACTOR WITHOUT ELECTRICAL LICENSURE: ONO EYES-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, I 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 /> '.CONTACT INFORMATION <br /> OWNER NAME: CFT NV Developments, LLC TENANT BUSINESS NAME(If Commercial): Panda Express ' <br /> OWNER MAILING ADDRESS: STREET 1683 Walnut Grove Ave <br /> c n Rosemead STATE CA ZIP 91770 <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: Drake Electric Inc <br /> CONTRACTOR ADDRESS: STREETRO. Box 736 <br /> CITY Fall City STATE WA ZIP 98024 <br /> CONTRACTOR PHONE:206.454.9487 CONTRACTOR EMAIL:Sdrake@drakeelectricinc.COm <br /> CONTRACTOR LIC.#(REQUIRED):DRAKEEI822BP CITY OF EVERETT BUSINESS LIC.#(REQUIRED):58583 <br /> PRIMARY CONTACT: DOWNER ❑✓CONTRACTOR ❑OTHER(Please Specify) Electrical Contractor <br /> CONTACT NAME: CONTACT PHONE:425.345.3768 <br /> Shawn Drake CONTACT EMAIL:Sdrake@drakeelectricinc.com <br /> AGREEMENT I hereby certify that/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 /> Shawn Drake 9.16.2019 E n o a` - \0c\ <br /> Owner/Authorized Agent Signature Date (Revised 1/11/2019) Page 1-Application <br />