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• • <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERE i I PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov l www.everettwa.govipermits <br /> PROJECT ADDRESS: ,L 00 k A- “ PA-k.K }ick-1) BUILDING AREA: sq ft <br /> PROJECT TYPE: Li NEW CONSTRUCTION ❑ADDITION ❑TENANT IMPROVMENT 0,REMODEL <br /> . BUILDING USE: El SFR ❑ TOWNHOUSE ❑. DUPLEX ❑ADU ❑MULTI-FAMILY-#OF UNITS; COMMERCIAL <br /> CONTRACT PRICE OF WORK:$ q 7 r ASSOCIATED BUILDING PERMIT#(if applicable p <br /> DESCRIBE SCOPE OF WORK: IPSr-4LL L-.0tt VOGrik-Ge .�'tiol' tT7 5y9E 1'1 /a4 <br /> gyrs.Riog S ko 4 p - <br /> Pt.a45o . kietvAr p .pilia r <br /> THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) <br /> LINE VOLTAGE WORK? Q NO ❑YES-Select Scope: ❑ Service ❑Feeder ❑Circuits-#: El Complete Re-wire <br /> LOW VOLTAGE WORK? ❑ NO El YES-#of Devices: <br /> SELECT SCOPE(REQUIRED): ❑ Data ❑ Intercom ❑Thermostat ®Audio ❑ 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 /> IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSON„ FACILITIES: <br /> AL CARE E3 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: 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 /> OWNER NAME: C C`/�Nl C9 a9 C-1 1 71 f;jI TENANT BUSINESS NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET l'! 0 1-4- -10)0..5 Oki P.0�Ir�) / t/� (� <br /> CITY iJ W L�✓!t STATE Go/'� ZIP �]$20 <br /> 3 <br /> OWNER PHONE: `f 25 4.3 —71 7 I OWNER EMAIL: <br /> CONTRACTOR NAME: Aronson Security Group <br /> CONTRACTOR ADDRESS: sTREET600 Oakesdale Avenue SW, Suite 100 <br /> crry Renton STATE WA zip 98057 <br /> CONTRACTOR PHONE:206-284-3553 CONTRACTOR EMAIL:paul.aronson@aronsonsecurity.com <br /> CONTRACTOR LAC #(REQUIRED):ARONSSG013C6 CITY OF EVERETT BUSINESS LAC #(REQUIRED):031987 <br /> 7,.+,dacT�r�.__....,a..n,_a� .,,. .._-, ..-. -, �,..r�,,.,: .�--.x -.arm_.._ ..gym „ ,_._4j:-. .�-. ,,, ..,cam. •. --..•,._. ....ter ..-..- .�x*. . _ -. - .;,.:m_- <br /> PRIMARY CONTACT: ❑OWNER El CONTRACTOR ['OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:206-245-1441 <br /> Paul Aronson CONTACT EMAIL:paul.aronson@aronsonsecurity.com <br /> AGREEMENT:I hereby certify that l 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 lam 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#: <br /> E mar (yA, <br /> Owner/Author zed Agent Signature Date (Revised 1/11/2019) Page 1-Application. <br />