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<br /> SR ELECTRICAL PERMIT APPLICATION
<br /> ul Y(,E EvERET1 kEY2Mt1 SFRVIEFS
<br /> EVERETT 32Sd CEDAR STREET.F<'ERETT,WA 9a2ei
<br /> il' : 7-E5i0 FFW.X 25-257-L4157 I(E.)eseiettepatiViwintioweTiov l wmvevocettwaA< Poim is
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<br /> PROJECT ADDRESS. 9t�b Evoleit mall Way RUA-DING AREA- t4 l',i+ +q Tt
<br /> PROJECT TYPE*, 0 NE'W CONSTRUCTION El AADDITION (✓.}TENANT IMPROYMENT [I REMODEL
<br /> BUILDING USE° Fl SFR 0 TOWNHOUSE 0 DUPLEX 0 ADU E MULTI:FAMIL°f a:OF UNITS.: Ctrs!?CCNIMFRC AI,
<br /> .E tic�ic.at �. + �r w 1NF MATIbi4. oEscRIPT! i _ '._,r
<br /> r
<br /> CONTRACT PRICE OF WORK:$ 18000 'ASSOCIATED BUILDING PERMIT N UIt a{r�:br`;abl_;:
<br /> DESCRIBE SCOPE OF WORK
<br /> Installation of telecom outlets , new server room,
<br /> THIS INSTALLATION INCLUDE THE FOLLOWING SCOPE:(SELECT ALL THAT APPLY)
<br /> LINE VOLTAGE WORK? NO El YE x Select Scope'0 Satvice 0 Feeder E rc C urts-t___._.._�.. [Ti Complete Ra e- ,Er
<br /> LOW VOLTAGE WORK? d NO 0 YES-If of Devices;12° tt^^,_t^^.��,, ta..
<br /> SELECT SCOPE IREC}UIRE0)-,• -.r Data Li Intercom El hnrmosial L. Audiu 0 Ste AL.;c I l aass S€ yt-4 Security ttrrr
<br /> 0 Fire Alarm.irlstenations under this pertr,.i fr ly include alectrrcdt witirig ttist,tlaoin of the.'System„An add1i onol
<br /> Fite Alarm Per Mil It Is required foe revir-w of deiace Lodi t era and ir,:>tall01i00 ap royai.
<br /> 163
<br /> ---? �ih2r i`Last All;r
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<br /> IS THIS PERMIT EDUCATION,INSTITUTIONAL.,HEALTH At40IQR PERSONAL CARE FACILITi€S. IYI N l 1'Yr;a•-Soo Below 6 Pg
<br /> By thecSing this bow, I am stating tint!I have road and urttferstand;MI of WAC 2911-46B-94D,,select:ert the specific reason on peon 2
<br /> — of this application(see next per),AND Plait Ri i ow rs NOT required because I Mee;ali rit r: ,fuJitay.iitc.sub sect ana that do riot
<br /> See Page a require Plan Review.
<br /> ARE YOU AN OWNER PERFORMING WORK THE CONTRACTOR WITHOUT ELECTRICAL LICENSURE:=•��;NO EYES-See Below 6 Pg.3
<br /> Pursuant to ROW 19:211261,poverty awrars and leaseholders canrirt perform-etectric4l work on butlttir±cus far rent,sole,or lease
<br /> without the proper electrical licensing and certification,or compiles) By checking this boa,I arts t1atinp that I have completed and
<br /> ,t,,v page 3 signed he AFFIDAVIT on page 3 4f this application to receive en EfarotriPliO"t'-,t„this iiCerIS lice,=rf,Walilin roan meat.
<br /> cos, lI IRmA►T1b f..
<br /> OWNER NAME; TENANT BUSINESS NAME(If Gotntnasrciatj:child;lr :
<br /> OWNER MAILING ADDRESS: slow 906 Everett Mall Way
<br /> VdA
<br /> c.„,. Everett are _.... z,98208
<br /> 'OWNER PHONE 4253535656 JOWNER EMAILttrtelu@smoinC0fseattle.corn
<br /> CONTRACTOR NAME: Far West Technologies Inc,
<br /> 'CONTRACTOR ADDRESS: sr'v0:1606 E Main St
<br /> ,;:rw Puyallup ,,R-WA t,9.8372
<br /> CUNTRAGTC7RPHs 1,tE:2532685379 CONTRACTOR EMAH_`rayt{[yfatWestIechnologies.cor71
<br /> CONTRACTOR LIC,1c(REQUIRFD);FARWt WTE98MJ 'CITY or EVERETT BUSINESS UC. REQUIRED:051415
<br /> PRIMARY CONTACT: hlOWNER ;11CONTRACTOR DOT HER{PteK,c.,Specify) __.,. _...
<br /> CONTACT NAME: CONTACT PHONE:2532685379
<br /> RoyTriana
<br /> tCONTACT IEMAILtroytt tarwastteChnelogies,00
<br /> .4t11e1<,t,eh:t 7 Ntrartfy ow*uteri nas a'roam:a+ad rcarirt:+a;r'AG apppk.etion*rid£sow toe same to de t+ue And orrefit A pain tiprlr of taws a,hrs nrKf41ee a ,Orn iart Chia
<br /> type of work wet be,oornpr.A.d whether*maw hero"or oar lilt prnttatq oho parrrr4 Ctnn rr not pretiume fa gore atstirwsty to mitts of canter trta ramvkliroeae nt»nr otters crate Or
<br /> forrd real reyutjfaip cxtrrastiudieet or the•pwelcuttmencs of rretnr+tL oe The I difit arrth ri aut Lyore Onrod,of;fail prop►ey to airrfc ro the w44(.go,wivril np, +catK" n,,ode errd I
<br /> cones ware tie Steele CoNractors taw 14t27 RCW and M.200 W4C. City or Evwont Qttiet49 t;..t Only
<br /> PERMIT s'
<br /> —�� 431,\L'71\1, _ W
<br /> E V21, 11, I �'
<br /> OwnertAuttrorized Agent Signatete Date '- ( etissed l er7%4O Page 1.Appl catien
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