101 E MARINE VIEW DR PACIFIC CABLE CONSTRUCTION 2022-05-24

L,,; ELECTRICAL PERMIT APPLICATION EVERETT OF EVERETT PERMIT SERVICES 3200CITY CEDAR STREET,EVERETT,WA 98201 WASHINGTON (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.govI wtiwv.everettwa.9ovfpermits PRNECT. TE IN oRA `Io g; . 1" , PROJECT ADDRESS: 101 E Marine Dr Everett 'BUILDING AREA:2 job trailers sq ft PROJECT TYPE: El NEW CONSTRUCTION ❑ADDITION Ei TENANT IMPROVMENT ❑ REMODEL BUILDING USE: ❑SFR O TOWNHOUSE ❑ DUPLEX ❑ADU ❑MULTI-FAMILY-#OF UNITS: [2]COMMERCIAL ELECTRICAL APPLICATION INFORMATION 'DE. RIPTION OF WORD 7, 1; 11 CONTRACT PRICE OF WORK:$ 8,000.00 lASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: One new 600 amp underground service for Pacific cable construction THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ❑ NO El YES-Select Scope: ❑✓ Service Feeder ❑Circuits-#: ❑Complete Re-wire LOW VOLTAGE WORK? ✓❑NO El YES-#of Devices: SELECT SCOPE(REQUIRED) ❑ Data ❑Intercom ❑ Thermostat ❑Audio O 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): CODE COMPLIANCE IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: ✓❑NO n YES--See Below&Pg.2 By checking this box,I am stating that I have read and understand all of WAC 29646B-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 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: Tim Jones TENANT BUSINESS NAME(If Commercial):Pacific Cable Construction OWNER MAILING ADDRESS: STREET PO Box 573 Waodenville SATE WA zip 98072 OWNER PHONE:206-730-5945 "OWNER EMAIL:tim{S paCCab.com CONTRACTOR NAME: OCSO Electric CONTRACTOR ADDRESS: STREET12215 Clear Lake South Rd E Eatonville STATE WA zip 98328 CONTRACTOR PHONE:253-318-3718 1CONTRACTOR EMAIL:derek@OSCoelectric.com CONTRACTOR LIC.#(REQUIRED):OSCOEE.811 B9 lCITY OF EVERETT BUSINESS LIC.#REQUIRED,):Receipt PRIMARY CONTACT: DOWNER OCONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:206-730-5945 Tim Jones CONTACT EMAIL:tiffl@paccab.com AGREEMENT:I hereby certify that I 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 t comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only L f PERMIT#: 1 Owner/Authorized Agent Signature Date (Revised 1l1112099) Page 1-Application