7431 EVERGREEN WAY TACO BELL 2022-02-03

EVERETT WASHINGTON IIDECTRICAL PERMIT APP' ATION CITY OF EVERETT PERMIT SERVICE" 3200 CEDAR STREET, EVERETT, WA 98201 (P) 425-257-8810 1 FAX 425-257-8857 1 (E) everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 7y31 EW.4(rl E %v^Y BUILDING AREA: 271 6 sq ft PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ ADDITION ❑ TENANT IMPROVMENT N REMODEL BUILDING USE: ❑ SFR ❑ TOWNHOUSE ❑ DUPLEX ❑ ADU ❑ MULTI -FAMILY - # OF UNITS: /0 COMMERCIAL ELECTRICAL APPLICATION INFORMATION & DESCRIPTION OF WORK CONTRACT PRICE OF WORK: $ S50 ASSOCIATED BUILDING PERMIT # (if applicable): DESCRIBE SCOPE OF WORK: 1V 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 ❑ 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): -514A/ CODE COMPLIANCE IS THIS PERMIT EDUCATION, INSTITUTIONAL, HEALTH AND/OR PERSONAL CARE FACILITIES: NO YES -- See Below & Pg. 2 ❑ By checking this box, I am stating that I have read and understand all of WAC 296-46B-900, 6lected 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: KjNo LJYES -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: /VoR7HNJ6sTERnI RES-rAv A►7 INC. TENANT BUSINESS NAME (If Commercial): 7'AGO BELL OWNER MAILING ADDRESS: STREET /8,4/,J 134"'1 AvE NE S7E C . CITY WOODiNV14C,E STATE A ZIP 9,007Z OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: J4EAT1-J oV0e7RWf.S-r CONTRACTOR ADDRESS: STREET 2-7/0 /0It7/4 S7_ C7- _S CITY /-A1Cf (tW9 STATE /k ZIP 98 Y95 CONTRACTOR PHONE:253 y9,S 704? f 1CONTRACTOR EMAIL: b r s a A h 0, west cow► CONTRACTOR LIC. #(REQUIRED): 1j(A7N APr 9t% 1 aZ ICITY OF EVERETT BUSINESS LIC. #(REQUIRED): %//,j/ 7 PRIMARY CONTACT: DOWNER CONTRACTOR ❑OTHER (Please Specify) CONTACT NAME: BQIAH 13jZ0SA/AiV CONTACT PHONE: 2S3 'Yq5- 7,9171 CONTACT EMAIL: bbrOt-nA/) heAAAin0/ 4-111 wes COM AUNLLMLN i : i hereby certity 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/ am authorized by the owner of this property to perform the work for which application is made and/ comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only PERMIT #: ®�� E 2ajet _c � �- thoriz nature.4�Date (Revised 111112019) Page 1-Application