1930 MERRILL CREEK PKY SQUARE PEG 2022-02-15

• • ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERT SERVICES EVERETT 3200 CEDAR STREET,EVERETT,WA 98201 WASti1a81-014 425-257.8810 1 FAX 425-2574857 I(E)everettepsaeverettwa.gov I www.averettwalawrpermits '117:71:7::::.:1272-717;',I=1;t;%1":474,1e; sn PROJECT ADDRESS: 1930 MeriliCreek Parkway BUILDING AREA: sq ft PROJECT TYPE: 0 NEW CONSTRUCTION El ADDITION rj TENANT IMPROVMENT 0 REMODEL BUILDING USE: El SFR ED TOWNHOUSE El DUPLEX El ADU 0 MULTI-FAMILY #OF UNITS: 0 COMMERCIAL 7.Ml I iti4404M04t4P,AP"PiCAIION,INOc TIOSI*1) 'entOPWORIC CONTRACT PRICE OF WORK:$ 10,000 !ASSOCIATED BUILDING PERMIT*(if applicable): DESCRIBE SCOPE OF WORK: Wire for new man lift equipment THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? El NO 0 YES-Select Scope:EI Service El Feeder 0 Circults-#:14 L.73 Complete Re-wire LOW VOLTAGE WORK? El NO El YES-#of Devices: SELECT SCOPE IREQUIRED): 0 Data El Intercom 0 Thermostat 7 Audio El Secure Access El Security System El 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): IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILMES: . NO YES—See Below&Pg 2 By checking this box,I am stating that I have read and understand all of WAC 296-44B-900,selected the specific reason on page 2 L— of this application(see next page),AND Plan Review is NOT required because I meet all of the fallowing 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 8,Pg.3 Pursuant to RCW 18,28,261,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 staling that I have completed and see paste 3 signed the AFFIDAVIT on page 3 of this application to receive an exemption from this licensing/certification requirement. CONTACT. 4noswri OWNER NAME: Square Peg Development TENANT BUSINESS NAME(If Commercial): Square Peg OWNER MAILING ADDRESS: slew 164 NE 145th Street Shoreline STATE WA 98155 zax, OWNER PHONE: 206 669-4642 OWNER EMAIL: CONTRACTOR NAME: Boyer Electric Company Inc, CONTRACTOR ADDRESS: sreeeT 8119 240th St SW Gay Edmonds srAn WA v., 98026 CONTRACTOR PHONE: 206 367-7606 !CONTRACTOR EMAIL: karen@boyerelectrio.00m CONTRACTOR LIC.AfiRECKHREDy BOYEREC1O'ILE tem OF EVERETT BUSINESS LIC.*REQUIRED):22147 PRIMARY CONTACT: DOWNER DCONTRACTOR DOTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 206 367-7606 Jacob Boyer CONTACT EMAIL: Jaoob@boyereleotrio.00m 'ACREEMENT:I hereby haat*,that haat,"and and esarroned this apptication and-anow ale same to be true and correct, AN proutsions of taws and ordinlmes ffakfeming this type of warn wine completed whether seecihed herein or not. The granengt ore permit does not presume to give authority to violate or cancel the prove4ons teeny other state or local law regulating constructron or the performance of construction. That I am authorized by the owner of This property to perform the work for which epsalcation is made end I comply with the State Contractors Law 18.27 RCW OM 296200 WAG. City of Everett Official tris*only 'PERMIT it: \-tk , E ' 909 C9 0 eriAutheri Agent Signature Date (Revised 1/1112010) —)0age 1-Application