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E CTRICAL PERMIT APPLIATION <br /> *Tr 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 /> PROJECT ADDRESS: 1205 Craftsman Way - Central Marina Improvis BUILDING AREA: N/A sq ft <br /> PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ADDITION ❑TENANT IMPROVMENT 0 REMODEL <br /> BUILDING USE: ❑SFR ❑TOWNHOUSE El DUPLEX ❑ADU ❑ MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> ELE :." ' °N ' "17: d workK, <br /> CONTRACT PRICE OF WORK:$ 455,522.00 ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIBE SCOPE OF WORK: <br /> Ph #4 Replacement of G dock. Work includes demolition of electrical at existing G dock and installation <br /> of electrical, lighting and Fire Alarm for the new G dock. <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? Ci NO ❑ YES-#of Devices: <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 /> El Other(List All): <br /> ................. ................... . _ <br /> s•� I ° CE <br /> IS THIS PERMIT EDUCATION,INSTITUTIONAL, HEALTH AND/OR PERSONAL CARE FACILITIES: L✓J 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: 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: Port of Everett TENANT BUSINESS NAME(If Commercial): Port Of Everett <br /> OWNER MAILING ADDRESS: STREET P.O. Box 538 <br /> clrY Everett STATE WA ZIP 98206 <br /> OWNER PHONE:425-388-0606 OWNER EMAIL: <br /> CONTRACTOR NAME: Service Electric Co., Inc. <br /> CONTRACTOR ADDRESS: STREET P.O. Box 1489 <br /> CITY Snohomish STATE WA ZIP 98291 <br /> CONTRACTOR PHONE:360-568-6966 CONTRACTOR EMAIL:Sharon@secoinc.com <br /> CONTRACTOR LIC.#(REQUIRED):SERVIEC564RU CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 029064 <br /> PRIMARY CONTACT: DOWNER ❑✓CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:360-568-6966 Ext#201 <br /> Sharon Card CONTACT EMAIL:sharon@secoinc.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 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 /> C`, PERMIT#: <br /> 5Lr i eit41 9-3-19 E \G\ OkLik <br /> Owner/Authorized Agent Signature Date (Revised 1/11/2019) Page 1-Application <br />