6600 MERRILL CREEK PKY TEAGUE 2022-02-22

MINN . • 112 ELECTRICAL PERMIT APPLICATION EVERETT CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 WASHINCaTON (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT ADDRESS: 6600 MERRILL CREEK PARKWAY SUITE2b BUILDING AREA: 25000 sq ft PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ADDITION ✓❑TENANT IMPROVMENT- ❑ REMODEL BUILDING USE: ❑SFR ❑TOWNHOUSE ❑ DUPLEX ❑ADU ❑ MULTI-FAMILY-#OF UNITS: COMMERCIA ICAL 4 . f R ._&DESCRIPTIOTOP CONTRACT PRICE OF WORK: $ 5000 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: INSTALL (2) 250V 30A RECEPTACLES & (5) 120V CORD REEL DROPS ''f THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ❑ NO ❑✓ YES-Select Scope: ❑Service ❑ Feeder ❑✓ Circuits-#:5 El Complete Re-wire LOW VOLTAGE WORK? O NO ❑ YES-#of Devices: SELECT SCOPE(REQUIRED) ❑ Data Cl Intercom El Thermostat ❑Audio ❑ Secure Access ❑ 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. ❑Other(List All): IS THIS PERMIT EDUCATION, INSTITUTIONAL, HEALTH AND/OR PERSONAL CARE FACILITIES: ✓❑ NO El YES--See Below&Pg.2 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 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 DYES-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. CO, CT IN g a ATI!. OWNER NAME: TENANT BUSINESS NAME(If Commercial): TEAGUE OWNER MAILING ADDRESS: STREET 6600 MERRILL CREEK PARKWAY SUITE 202 EVERETT STATE WA ZIP 98203 OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: PRIDE ELECTRIC, INC. CONTRACTOR ADDRESS: STREET 18133 NE 68TH STREET, SUITE D-120 CITY REDMOND STATE WA ZIP 98053 CONTRACTOR PHONE:4257362407 CONTRACTOR EMAIL: CONTRACTOR LIC.#(REQUIRED):PRIDEEI077DR CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 27137 ��"4 '� m PRIMARY CONTACT: DOWNER OCONTRACTOR ❑OTHER � �� _ �(Please Specify) CONTACT NAME: CONTACT PHONE:2064066912 KEN HAR CONTACT EMAIL:khair@prideelectric.com AGREEMENT:I hereby certify that!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 I am authorized by the owner of this property to perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only PERMIT#: �� JUSTIN BRANSON 8 1a 19 E I0(?) Owner/Authorized Agent Signature Date (Revised 1/11/2019) Page 1-Application