2505 PACIFIC AVE LOWES 2021-04-01

• ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits .71 PROJECT ADDRESS: 2505 Pacific Ave, WA 98201 BUILDING AREA: sq ft PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ADDITION ❑TENANT IMPROVMENT ❑ REMODEL BUILDING USE: ❑SFR ❑ TOWNHOUSE ❑ DUPLEX El ADU ❑MULTI-FAMILY-#OF UNITS: ❑✓ COMMERCIAL efi,i;7 �I !049r ®T;I'i-l.77_J 1;,, i�Jl �K Ali lZPITET ..:7.- _ --:I CONTRACT PRICE OF WORK:$ 12363.60 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: Add fixtures and power to bays. THIS INSTALLATION INCLUDES THE FOLLOWING 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: SELECT SCOPE(REQUIRED): ❑ Data ❑Intercom ❑ Thermostat ❑Audio ❑ Secure Access ❑ Security System Cl Fire 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): ;,}� 4��k1i s�7� t .¢�� ^ sT �a �- .,. r �S".` �}., - y i -t _ �. t rr 5. 0 B B 0 :yy 0 +r� r- i� r s° a a�. h .n_1..u._..._. • t �• ��=-...�_. . ..s_..- ....t r:-.i..� Jrt-t��r•��!�. 1.. rii•...�y 7...,��.-_.. .. Z r�. � - �n _t1'L. SJ T1 IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: 111 NO 11 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: •NO AYES-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. r ° til)im." °1(tI,07 .e `T , OWNER NAME: [OWES COMPANIES TENANT BUSINESS NAME(If Commercial : OWNER MAILING ADDRESS: STREET 160 Curtis Bridge Rd CITY Wilkesboro STATE NC ZIP 28697 OWNER PHONE:18004456937 OWNER EMAIL: CONTRACTOR NAME: West Coast Lighting& Energy Inc. CONTRACTOR ADDRESS: STREET18550 Minthorn St CITY Lake Elsinore STATE CA ZIP 92530 CONTRACTOR PHONE:951-296-0680 CONTRACTOR EMAIL:orwa@wcleinc.com CONTRACTOR LIC.#(REQUIRED):EC WESTCCL929B CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 047162 PRIMARY CONTACT: Q✓OWNER ❑CONTRACTOR BOTHER(Please Sped ) CONTACT NAME: CONTACT PHONE:951-296-0680 Micah Hazen CONTACT EMAIL:orwa@wcleinc.com 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 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 comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only PERMIT#: E.'1-� 7s= E ��) 0- £( ` ,,em Owner/Authorized ent SSif nature Date (Revised 1/11/2019) Page 1-Application