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illt <br /> ECTRICAL PERMIT APPLICATION <br /> 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 /> 477 <br /> . % r PROJECT SITE INFORMA;°. '` ...r! <br /> PROJECT ADDRESS: 2802 Wetmore Ave BUILDING AREA: 100o sq ft <br /> PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ADDITION ✓❑TENANT IMPROVMENT ❑ REMODEL <br /> BUILDING USE: ❑SFR ❑TOWNHOUSE ❑ DUPLEX ❑ADU ❑ MULTI-FAMILY-#OF UNITS: ✓❑COMMERCIAL <br /> ELCTR CAL APPLICATION INFORM; ;lN*DESCRIPTIf N F WORK <br /> CONTRACT PRICE OF WORK: $ 1500 ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIBE SCOPE OF WORK: <br /> They are replacing the elevators and we are adding a relay module and 2 monitor modules for the new <br /> elevator cars. <br /> THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) <br /> LINE VOLTAGE WORK? 0 NO ❑YES-Select Scope: ❑ Service ❑ Feeder ❑Circuits-#: ❑ Complete Re-wire <br /> LOW VOLTAGE WORK? ❑ NO ❑✓ YES-#of Devices:3 <br /> SELECT SCOPE(REQUIRED): ❑ Data ❑ Intercom ❑Thermostat ❑ Audio ❑ Secure Access ❑ Security System <br /> 0 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 /> 1 . , ^, .,- eODE COMPLIANCE <br /> IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: ❑ NO OP YES--See Below&Pg.2 <br /> ❑ B tchhie cakpinp itchaisi obno x(,s Ie ae mn etxat tipgg teh)a,tA I NhDa vPel read eavnide wunderstand <br /> qulil roefd WbeAcCa u2s9e6-4 <br /> Im6eBet9 a00ll,o sf ethle c..o"lil <br /> lo tw ings spe isficc rtieoanss otnot nd op angoe 2 <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 /> CONTACT INFORMATION . <br /> OWNER NAME: Funko LLC TENANT BUSINESS NAME(If Commercial): Funko <br /> OWNER MAILING ADDRESS: STREET 2802 Wetmore Ave <br /> c,,, Everett STATE WA zip 98201 <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: Western States Fire Protection <br /> CONTRACTOR ADDRESS: STREET 14690 NE 95th St#101 <br /> CITY Redmond STATE WA zip 98052 <br /> CONTRACTOR PHONE:425-881-0100 CONTRACTOR EMAIL:seth.zehnder@wsfp.us <br /> CONTRACTOR LIC.#(REQUIRED):WESTESF906P1 CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 020553 <br /> PRIMARY CONTACT: DOWNER ❑✓CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:425-478-9709 <br /> Seth Zeh nder CONTACT EMAIL:seth.zehnder@wsfp.us <br /> AGREEMENT:I hereby certify that 1 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 1 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 /> PERMIT#: <br /> ` - <br /> 2/17/2021 E Z\ 03 _ ool <br /> Owne,Au .rized Agent Signature Date (Revised 1/11/2019) Page 1-Application <br />