2930 MAPLE ST KAISER PERMANENTE 2020-12-31

CLECTRICAL PERMIT APPLIATION OLT CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 2930 Maple street Everett WA 98201 BUILDING AREA: loon sq ft PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ADDITION ✓❑ TENANT IMPROVMENT ❑ REMODEL BUILDING USE: ❑SFR ❑ TOWNHOUSE ❑ DUPLEX ❑ADU ❑ MULTI-FAMILY-#OF UNITS: ✓❑ COMMERCIAL ELECTRICAL APPLICATION INFORMATION & DESCRIPTION OF WORK\...—,--- CONTRACT PRICE OF WORK: $ 2900 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: Low voltage DDC controls for trofit for heat pump controls. THIS INSTALLATION INCLUDES THE FOLLOWING SCO (SELEcT ALL THAT APPLY) LINE VOLTAGE WORK? ✓❑ NO E YES-Sele6t.S pe: ❑ Serivice ❑ Feeder ❑ Circuits-#: ❑ Complete Re wire LOW VOLTAGE WORK? ❑ NO ❑✓ YES-#of De ices:2 SELECT SCOPE(REQUIRED): ❑ Data ❑ Intercom ✓❑The ostat ❑Audio ❑ Secure Access ❑ Security System ❑ Fire Alarm- Installation this permit only include electrical wiring rough-in of the system.An additional Fire Alarm Permit is required for review of device location and installation approval. ❑ Other(List All): CODE COMPLIANCE IS THIS PERMIT EDUCATION, INSTITUTIONAL, HEALTH AND/OR PERSONAL CARE FACILITIES: ❑ NO ✓❑YES--See Below& Pg. 2 IBy 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 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 YOU AN OWNER PERFORMING WORK AS THE CONTRACTOR WITHOUT ELECTRICAL LICENSURE: ENO 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: Kaiser Permanente TENANT BUSINESS NAME(If Commercial): Kaiser Permanente OWNER MAILING ADDRESS: STREET 2930 Maple ST Everett WA 9801 CITY STATE STATE WA ZIP 98201 OWNER PHONE:425-261-1500 OWNER EMAIL: CONTRACTOR NAME: EC E1ectric CONTRACTOR ADDRESS: STREET981 Powell Ave S, Suite 200 ciry Renton STATE V V^' A ZIP 98057 CONTRACTOR PHONE:206-436.6070 CONTRACTOR EMAIL: CONTRACTOR LIC.#(REQUIRED):EC ECCOM**148BA CITY OF EVERETT BUSINESS LIC.#(REQUIRED):051774 PRIMARY CONTACT: ['OWNER ❑✓CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:206-715-3814 Michael Griffin CONTACT EMAIL:mike.griffin©ecpowerslife.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#: 11-25-2019 E \ _ 1C, 3 _ Owner/Authorize gent Signature Date (Revised 1/11/2019) Page 1-Application