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ECTRICAL PERMIT APPLIIVTION <br /> CITY OF EVERETT PERMIT SERVICES <br /> EVERETT 3200 CEDAR STREET,EVERETT,WA 98201 <br /> WASHINGTON (P)425-257-8810 j FAX 425-257-8857 1(E)everetteps@everettwa.gov I www.everettwa.govipermits <br /> ' :17 <br /> PROJECT ADDRESS: 8317 5th Avenue West BUILDING AREA: 1,096 sq ft <br /> PROJECT TYPE: ía NEW CONSTRUCTION Ell ADDITION Li TENANT IMPROVMENT LI REMODEL <br /> BUILDING USE: El SFR E:1 TOWNHOUSE El DUPLEX El ADU ía MULTI-FAMILY-#OF UNITS: E]COMMERCIAL <br /> EL: ALAPUCATIONINWilou*DESCRiFilitWOr-WORK <br /> CONTRACT PRICE OF WORK: $ 6,907.00 ASSOCIATED BUILDING PERMIT#(if applicable): C1701-018 <br /> DESCRIBE SCOPE OF WORK: <br /> Wire apartment to code. <br /> THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) <br /> LINE VOLTAGE WORK? D NO El YES-Select Scope:D Service El Feeder E Circuits-#:15 C Complete Re-wire <br /> LOW VOLTAGE WORK? LI NO El YES-#of Devices:3 <br /> SELECT SCOPE(REQUIRED): El Data El Intercom 0 Thermostat El Audio CI Secure Access LI Security System <br /> ía Fire Alarm-Installations under this permit only include electrical wiring rough-in of the system.An additional <br /> Fire Alan-n Permit is required for review of device location and installation approval. <br /> EI Other(List All): <br /> CODE COMPLITANOIE <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: ENO 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 /> ,-) 4(1:1114FOR <br /> OWNER NAME: Seattle Development Assoc., LLC TENANT BUSINESS NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 1122 130th Street SE -#A <br /> CITY Everett STATE WA ,,p 98208 <br /> OWNER PHONE:206-830-0126 OWNER EMAIL:SDAhOMeS@gfilait,COM <br /> CONTRACTOR NAME: Tughan Electric, Inc. <br /> CONTRACTOR ADDRESS: STREET1911 235th Court NE <br /> CITY Sammamish sTATE WA zfp 98074 <br /> CONTRACTOR PHONE:425-868-8072 CONTRACTOR EMAIL:Larry@tughanelectric.com <br /> CONTRACTOR LIC.#(REQUIRED):TUGHAEi943BP CITY OF EVERETT BUSINESS LIC.UREQUIRED):044481 <br /> • • •— . . <br /> PRIMARY CONTACT: E OWNER DCONTRACTOR DOTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:206-830-0126 <br /> Ed is Kulaaa <br /> CONTACT EMAIL:ediskulaga@gmaii.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 Sta ontracto taw 18.27 ROW and 296.200 WAG. City of Everett Official Use Only <br /> PERMIT#: <br /> 5/20/2019 E noS - <br /> wnerfAuthor gent Signature Date (Revised 1/11/2019) Page -Application <br />