Laserfiche WebLink
ELE TRICAL PERMIT APPLICAAON <br /> 'IP CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> ,ti ,. . i'ROJECt SITE INFORMATION <br /> PROJECT ADDRESS: 2505 Pacific Ave, WA 98201 BUILDING AREA: sq ft <br /> PROJECT TYPE: LI NEW CONSTRUCTION LI ADDITION ❑TENANT IMPROVMENT ❑ REMODEL <br /> BUILDING USE: ❑ SFR ❑ . .• HOUSE ElDUPLEX ❑ADU El MULTI-FAMILY-#OF UNITS: 71 COMMERCIAL <br /> CONTRACT PRICE OF WORK:$ 6274.35 ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIBE SCOPE OF WORK: <br /> Run power from av ilable power in ceiling, drop down to racking for trim a tree display. <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: <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 /> E Other(List All) <br /> IS THIS PERMIT EDUCA <br /> , COMECOMPUAIRCIE „ tea. V <br /> TION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: �,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 /> / <br /> ARE YOU AN OWNER PERFORMING WORK AS THE CONTRACTOR WITHOUT ELECTRICAL LICENSURE: .M NO EYES-See Below&Pg. 3 <br /> — Pursuant to RCW 19.28.261, property owners and leaseholders cannot perform electrical work on .'il.ings 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: Lowes Companies TENANT BUSINESS NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 160 Curtis Bridge RD (� <br /> CITY Wilkesboro STATE '^f ZiP 28697 <br /> OWNER PHONE: 18004456937 OWNER EMAIL: <br /> CONTRACTOR NAME: West Coast Lighting & Energy, INC. <br /> CONTRACTOR ADDRESS: STREET 18550 Minthorn ST <br /> Dry Lake Elsinore STATE CA ziP 92530 <br /> CONTRACTOR PHONE:951-296-0680 [CONTRACTOR EMAIL:orwa©wcleinc.corn <br /> CONTRACTOR LIC.#(REQUIRED):EC WESTCCL929B ]CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 047162 <br /> PRIMARY CONTACT: ['OWNER ❑CONTRACTOR ❑OTHE R(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:951-296-0680 <br /> Micah Hazen CONTACT EMAIL:orwa©wcleinc.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 try the owner of this property to perform the work for which application is made and I <br /> comply with the,St@te Contractors Law 18.27 RCW and 296,200 WAC. City of Everett Official Use Only <br /> PERMIT#: <br /> --_ ;7 ,,,,,,/ ,A171 E l_ ck OS , 00 <br /> ner/A h9fize gnature' Date (Revised 1111/2019) Page 1-Application <br />