3002 COLBY AVE CHICAGO TITLE 2021-11-02

• ELECTRICAL PERMIT APPLICATION EVERETT 32 CITY OF EVERETT PERMIT SERVICES 00 CEDAR STREET,EVERETT,WA 98201 WASHINGTON (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.goviperrnits PROJECT SITE INFORMATION`' PROJECT ADDRESS: 3002 Colby Ave. #200 Everett WA 98201 BUILDING AREA: 5000 so ft PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ADDITION ®TENANT IMPROVMENT ❑REMODEL BUILDING USE: El SFR El TOWNHOUSE ❑ DUPLEX ❑ADU ❑ MULTI-FAMILY-#OF UNITS: ❑✓ COMMERCIAL ELECTRICAL APPLICATION INFORMATION & DESCRIPTION OF WORK CONTRACT PRICE OF WORK:$ 36,252 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: Energy Conservation Lighting Retrofit Remove Fluorescent tubes replace with LED THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE:(SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ❑ NO ❑✓ YES-Select Scope: ❑Service ❑ Feeder ❑Circuits-#. 4 ❑Complete Re-wire LOW VOLTAGE WORK? ❑ NO El YES-#of Devices: SELECT SCOPE(REQUIRED): ❑ Data ❑ Intercom El Thermostat El Audio ❑Secure Access ❑ Security System ❑ 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):Retrofit to LED CODE-COMPLIANCE IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: ENO E YES—See Below&Pg.2 By checking this box,I am stating that I have read and understand all of WAC 29646B-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: ONO DYES-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. CONTACT INFORMATION OWNER NAME: Mark Reichlin TENANT BUSINESS NAME(If Commercial):Chicago Title Insurance Cc OWNER MAILING ADDRESS: STREET PO Box 13261 am, Everett STATE WA z,p 98206-3261 OWNER PHONE:(206) 510-2548 OWNER EMAIL: markr@wes-construction.com CONTRACTOR NAME: Seahurst Electic CONTRACTOR ADDRESS: STREET 2915 Chestnut Street cry Everett STATE WA zip 98201 CONTRACTOR PHONE: (425) 754-0532 CONTRACTOR EMAIL:thinde@Seahurst,corn CONTRACTOR LIC.#(REQUIRED): SEAHUE1099QN CITY OF EVERETT BUSINESS LIC.#(REQUIRED):18763 PRIMARY CONTACT: DOWNER QCONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: (425) 754-0532 Tom inde CONTACT EMAIL: thinde@seahurst.com AGREEMENT t 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 wilt 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 Slate Contractors Law 18 27 RCW and 296.200 WAC. City of Everett Official Use Only PERMIT* /)/)7 ! E10111 ' i�� Owner/Authorized Agent Signature Date (Revised 1/11/2019) Page'I-Application