4727 EVERGREEN WAY GEORGE ORTHODONTICS 2021-02-22

• tLECTRICAL PERMIT APPLItATION EVERETT CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 WASHINGTON (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 4727 Evergreen Way Everett, WA 98203 BUILDING AREA: 1430 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: $ 19,1 O0 O0O.,.,L� ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: Installing one set single faced illuminated building sign to roof. Installing one illuminated wall sign on side of building. New wall sign will replace existing wall sign that is larger than Everett Municipal City Code. THIS INSTALLATION INCLU' r S THE F c LLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ❑✓ NO YES-Select Scope: ❑ Service ❑ Feeder ❑ Circuits-#: ❑ Complete Re-wire LOW VOLTAGE WORK? ❑ NO YES-#of Devices:2 SELECT SCOPE(REQUIRED : ❑ Data ❑ Intercom ❑ Thermostat ❑Audio ❑ Secure Access ❑ Security System ire Alarm-Installations under 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):Connecting two signs into sign circuit. CODE COMPLIANCE IS THIS PERMIT EDUCATION, INSTITUTIONAL, HEALTH AND/OR PERSONAL CARE FACILITIES: ✓❑ NO ❑ YES--See Below&Pg. 2 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 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: LINO 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: Michael George TENANT BUSINESS NAME(If Commercial): George Orthodontics OWNER MAILING ADDRESS: STREET 4727 Evergreen Way clTy Everett STATE WA zip 98203 OWNER PHONE:425-327-1025 OWNER EMAIL:tamerongeorge©gmail.com CONTRACTOR NAME: NW Signs CONTRACTOR ADDRESS: STREET 17201 Beaton RD SE CITY Monroe STATE WA ZIP 98272 CONTRACTOR PHONE:425-844-6415 CONTRACTOR EMAIL:Jason@nwsigns.com CONTRACTOR LIC.#(REQUIRED):NWSIGS*84201 CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 53882 PRIMARY CONTACT: DOWNER ZCONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:Jason Taisey Jason Talsey CONTACT EMAIL:425-844-6415 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 regulatin onstruction 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 t state Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only PERMIT#: wner/Authori d- gent Signature Date (Revised 1/11/2019) Page 1-Application t