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ECTRICAL PERMIT APPLIPATION <br /> 477- 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: 607 Riverside Rd BUILDING AREA: 5800 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 St:DESCRIPTION OF WORK. <br /> CONTRACT PRICE OF WORK:$ 6,000.00 ASSOCIATED BUILDING PERMIT#(if applicable): r) Il (\,1 °col <br /> DESCRIBE SCOPE OF WORK: <br /> Low Voltage 24 devices 1 controller <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:24 <br /> SELECT SCOPE(REQUIRED): ✓❑ Data ❑ Intercom ❑Thermostat ❑Audio El 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 /> CODE COMPLIANCE <br /> IS THIS PERMIT EDUCATION, INSTITUTIONAL, HEALTH AND/OR PERSONAL CARE FACILITIES: ✓❑ NO El 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: ❑✓ NO 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: Panattoni Development Co TENANT BUSINESS NAME(If Commercial): Compass Canteen-Glacier Peak <br /> OWNER MAILING ADDRESS: STREET 900 SW 16th St,Suite 330 <br /> cimv Renton STATE WA zip 9805 <br /> OWNER PHONE:206-248-0280 OWNER EMAIL: Dbelk@Panattoni.com <br /> CONTRACTOR NAME: Mastercraft Electric, Inc. <br /> CONTRACTOR ADDRESS: STREET206{Frontage Rd N,Suite A2 <br /> CITY Pacific STATE WA Z1P 98047 <br /> CONTRACTOR PHONE:253-737-4367 CONTRACTOR EMAIL:Carlosc@Mastercraftinc.com <br /> CONTRACTOR LIC.#(REQUIRED):MASTEEI127B8 CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 055704 <br /> PRIMARY CONTACT: DOWNER ❑✓CONTRACTOR ['OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:509-302-8218 <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 /> CAJA/� A1, , �A PERMIT <br /> ##:i� I(�) <br /> wS r StAtA 12/31/19 E r ( D I -002 <br /> Owner/Authorized Agent Signature Date (Revised 1/11/2019) Page 1-Application <br />