3214 BROADWAY BROADWAY KINECT APARTMENTS 2022-01-13

n • ELECTRICAL PER T APPLICCOOI 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 _ -4L- - . PROJECT SITE I PORMATIa - - PROJECT ADDRESS: 3 Z1 1 '✓O rl~) (BUILDING AREA: sq ft (PROJECT TYPE: -{JEW CONSTRUCTION ®ADDITIO 0 TENANT IMPROVMENT ®REMODEL 'BUILDING USE: ® SFR 0 TOWNHOUSE • DUPLEX L. ADU 0 MULTI-FAMILY-#OF UNITS: OMMERCIAL ELECTRICAL AIR( A LQI' : .„ ._Ni T�®� a° � A PI Q fif!►OR C iCONTRACT PRICE OF WORK: �0 Q . ASSOCIATED BUILDING PERMIT#(if applicable): or DESCRIBE SCOPE OF WORK: �� s�`/ C�3..�t�� V. iri he Sli-m�-s • i I THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? 0 NO ❑YES-Select Scope: X Service ® Feeder 0 Circuits-#: 0 Complete Re-wire LOW VOLTAGE WORK? 0 NO X YES-#of Devices: SELECT SCOPE(REQUIRED): ®Data 0 Intercom 0 Thermostat 0 Audio .0 Secure Access 0 Security System 0 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. 0 Other(List All): - - CODE:COMPLIANCE`: ___ IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: • NO I. YES -See Below&Pg.2 ElBy 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: ONO OYES-See Below&Pg.3 i 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: fro Ad, .._c ilea( • c 32.t f L.i.G i .44 41 u*e 41', . . ay/1 14 - - ° ' // OWNER MAILING ADDRESS: STREET //D • Abe. NE... = Ssv CITY /39J{ Y Lt V, STATE /4)14 . ZIP Fi. Doi OWNER PHONE:Li ZS look-ZZ'JTi OWNER EMAIL ,x - .�n• ,CONTRACTOR NAME: 5 r y 1 o ktyPeIn T £( fG1� /c >�oz_ CONTRACTOR ADDRESS:3g IO STREET I l&kY). PL N it?-U �f ..- _ CITY f '1'Qr STATE Z I P C I Z23 i. , (CONTRACTOR PHONE:442.5 CONTRACTOR EMAIL: A , • A_, . do C: ►, , ),C ' .933I?)f3 CITY OF EVERETT BUSINESS LIC.#(R QUIRED): 0 b S-S I ;CONTRACTOR LIC.#(REQUIRED ' .. -,..,. ,PRIMARY`CONTACT: ❑OWNER * piCONTRACTOR 0 OTHER(Please Specify) 'CONTACT NAME: CONTACT PHONE: G/Zs 7S0) • 34622-• • 0 a Y/s/a rkri CONTACT EMAIL: I'YlA r1'hJAo SI'H 2 lJ 01l17d�{..C.flC 4 Ld AGREEMENT*I hereby certify that 1 have read and examined this application and know the same to be true and correct. All provisiort 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 lam authorized by the owner of this property to perform the work for which application is made and I City of Everett Official Use Only comply with the State Contractors Law 18.27 RCW and 296.200 WAC. P ERM IT#: • Cr 4t, �� E10, lbs . Authorize ge Signature Date (Revised 1/11/2019) Page 1-Application