1700 W MARINE VIEW DR 2022-02-28

0 MI ELECTRICAL PERMIT APPLICATION EVERETT CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 WASHINGTON (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 1 C2 'A) !\-1a ri n tj i p t:) PR BUILDING AREA: sq ft PROJECT TYPE: ❑ NEW CONSTRUCTION X ADDITION ❑TENANT IMPROVMENT ❑ REMODEL , BUILDING USE: ❑SFR ❑ TOWNHOUSE ❑ DUPLEX ❑ADU ❑ MULTI-FAMILY-#OF UNITS: COMMERCIAL ELECTRICAL APPLICATION INFORMATION & DESCRIPTION OF'WORK ASSOCIATED BUILDING PERMIT#(if applicable): 6 I I CONTRACT PRICE OF WORK:$ 3 �,(, (" '--' PP� )� ;C` � -GEC DESCRIBE SCOPE OF WORK: \• tl �> Roc r acid , 4 ;01- ,.0 �Gt,c_11 Roc m . P- 3 C- L/ X A,r'C�.�i•t f _ _ .>—C, V / it C /3Ci ��ti t- ,-- (,)_---) 1--C viI iri'v&� CC f•1r cam d i ✓ (rnrra on 1 Ccttt c1 ) THIS INSTALLATION INCLUDES THE FOOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ❑ NO YES-Select Scope: ❑ Service ❑ Feeder ❑ Circuits-#: -CAE Complete Re-wire LOW VOLTAGE WORK? ❑ NO AYES-#of Devices: )- U CC__ \ �/'. x 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): 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-90 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: gNO ['YES-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: K / TENANT BUSINESS (If Commercial): r C l�n r �L� e�n�' NAME ) -'['C< t:- ti cc I OWNER MAILING ADDRESS: STREET L CI 1,0 ► 1 kr rE 1,)t @A� T'�� CITY (�t C' STATE I:V f� ZIP q J ( OWNER PHONE )-G'6--333 ^ 3 r 3 OWNER EMAIL: CONTRACTOR NAME: I— t tZ h ,'t 0- -.1 pc 1-� of CONTRACTOR ADDRESS: STREET i i. C' S 3 '----ft" e L CITY /e{ c VO (+\J�d J1 STATE iJ‘./A CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LIC.#(REQUIRED) L14 tt 1 r 7(- .,-, CITY OF EVERETT BUSINESS LIC #( EQUIRED €Q t 0,, PRIMARY CONTACT: XOWNER ❑CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: a—C' . .. CONTACT EMAIL: > T7lc• � ,e—vrt IN E'�t� •��; t'J 1 a- �Y' rl el N��l"� C � � 1 AGREEMENT:I hereby certify that I and examined this application and know the same to be true and correct. Al!provisions of laws and rdinances governing this type of work will be completed ether specified he ' 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 constructi n or the erformance of co truction. That I am authorized by the owner of this property to perform the work for which application is made and I comply with the State Cont 1 .27 RCW and 2 .200 WAC. City of Everett Official Use Only PERMIT#: VA) CI 0 ) C �'9 E n l0 -- �`� - C �F (Revised 1/11/2019) Page 1-Application Owner/ uthorized Agent Signature D to 9 PP