8417 EVERGREEN WAY PANDA EXPRESS 2022-05-23

11. wi ELECTRICAL PERMIT APPLICATION EVERETT CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 WASHINGTON (P)425-257-8810 1 FAX 425-257-8857 1(E)everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 8417 Evergreen Way Everett, WA 98208 BUILDING AREA: 2000 sq ft PROJECT TYPE: ❑✓ NEW CONSTRUCTION ❑ADDITION ❑TENANT IMPROVMENT ❑ REMODEL BUILDING USE: ❑SFR E TOWNHOUSE ❑ DUPLEX ❑ADU ❑ MULTI-FAMILY-#OF UNITS: ❑✓ COMMERCIAL ELECTRICAL APPLICATION INFORMATION & DESCRIPTION OF WORK CONTRACT PRICE OF WORK:$ 1200 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: Install (4) speakers, amplifier and volume control THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ❑✓ NO ❑YES-Sel,6t Scope: ❑ Servide E Feeder ❑Circuits-#: E Complete Re-wire LOW VOLTAGE WORK? E NO ❑✓ YES- Devices:6 �� SELECT SCOPE(REQUIRED): ❑ Data ❑ Intercom ❑Thermo,etat ✓❑Audio ❑ Secure Access E Security System ❑ Fire Alarm-Installa ns underjtais permit only include electrical wiring rough-in of the system.An additional Fire Alarm Permit is requiredlor review of device location and installation approval. ❑Other(List All): CODE COMPLIANCE IS THIS PERMIT EDUCATION,INSTITUTIONAL, HEALTH AND/OR PERSONAL CARE FACILITIES: 7N ❑YES--See Below&Pg.2 LiBychecking 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 YOUAN 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: Panda Express TENANT BUSINESS NAME(If Commercial): Panda Express#3078 OWNER MAILING ADDRESS: STREET 1683 Walnut Grove Ave C,Ty Rosemead STATE CA ZIP 91770 OWNER PHONE:626-799-9898 OWNER EMAIL: CONTRACTOR NAME: Audio Video Exclusives LLC 0� (51k9il/1A____- CONTRACTOR ADDRESS: STREET 7528 Olympic View Drive Suite#110 CITY Edmonds STATE WA ZIP 98026 CONTRACTOR PHONE:425-245-8846 CONTRACTOR EMAIL:craig@avexclusives.com .. \, CONTRACTOR LIC.#(REQUIRED):EC LEIBOC*8760E CITY OF EVERETT BUSINESS LIC.#(REQUt ED): 52755 / PRIMARY CONTACT: DOWNER ❑✓CONTRACTOR ['OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:425-245-8846 \-.`-` "` Craig Holmes CONTACT EMAIL:Craig @avexclusives.Com 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 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 I comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only PERMIT#: <-7) ( ' I — 21 "- 2-0 E Zee - ' [-n-- Owner/A riz • :•ent Signature Date (Revised 1/11/2019) Page 1-Application