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• • <br /> 4ffrr ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (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: 6605 Hardeson Rd BUILDING AREA: sq ft <br /> PROJECT TYPE: El NEW CONSTRUCTION El ADDITION El TENANT IMPROVMENT 0 REMODEL <br /> BUILDING USE: ❑SFR El TOWNHOUSE El DUPLEX ❑ADU El MULTI-FAMILY-#OF UNITS: ❑✓ COMMERCIAL <br /> ELECTRICAL APPLICATION INFORMATION & DESCRIPTION OF WORK <br /> CONTRACT PRICE OF WORK: $ 2000 ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIBE SCOPE OF WORK: <br /> Exterior Light retrofit (19) lights <br /> THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) <br /> LINE VOLTAGE WORK? ❑ NO ❑✓ YES-Select Scope: ❑ Service El Feeder ❑✓ Circuits-#:4 ❑ Complete Re-wire <br /> LOW VOLTAGE WORK? 0 NO ❑YES-#of Devices: <br /> SELECT SCOPE(REQUIRED): ❑ Data ❑ Intercom ❑Thermostat El Audio El Secure Access El 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 /> El Other(List All): <br /> CODE COMPLIANCE <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: ENO 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, 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: Hogland Transfer Center TENANT BUSINESS NAME(If Commercial): Hogland Transfer Center <br /> OWNER MAILING ADDRESS: STREET 6605 Hardeson Rd DIT„ Everett STATE ••�/��A Zip 98203 <br /> OWNER PHONE:425-407-0217 OWNER EMAIL: <br /> CONTRACTOR NAME: Mastercraft Electric, Inc. <br /> CONTRACTOR ADDRESS: STREET206 Frontage Rd N,Suite A2 <br /> CITY Pacific STATE WA ZIP 98047 <br /> CONTRACTOR PHONE:253-737-4367 CONTRACTOR EMAIL:Carlosc@Mastercraftinc.com <br /> CONTRACTOR LIC.#(REQUIRED):MAsTEE112768 CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 055704 <br /> PRIMARY CONTACT: EOWNER ['CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: ,,I CONTACT PHONE:253-737-4367 <br /> Carlos Castaneda CONTACT EMAIL:CarlosC@Mastercraftinc.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// #: I'� <br /> r—DocuSigned by: <br /> 2/3/2020 E 2 0 �"v (/1 / - 0 t <br /> /✓� <br /> Owner/Authorized Agent Signature Date (Revised 1/11/2019) Page 1-Application <br /> \-4FBDB217C11845F... <br />