906 SE EVERETT MALL WAY COLUMBIA DEBT RECOVERY 2022-06-28

EoCTRICAL PERMITMIT APPLSERVICATION 4/Err CITY OF EVERETT PER 3200 CEDAR STREET, EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa„gov I wwvw.everettwa.gov/permits ROJECT SITE INFORMATION PROJECT ADDRESS: 906 SE Everett Way ^., BUILDING AREA: 6000 sq ft PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ ADDITION 0 TENANT IMPROVMENT ❑ REMODEL BUILDING USE: ❑ SFR ❑ TOWNHOUSE ❑ DUPLEX I I ADU I_I MULTI-FAMILY-#OF UNITS: ❑✓ COMMERCIAL ELECTRICAL APPLICATION INFORMATION & DESCRIPTION OF WORK CONTRACT PRICE OF WORK: $ 20000 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: relocate lights; install switch; occ sensor; receptacles; dedicated circuits; furniture whips; ,9n2 - 0110 . THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ❑✓ NO ❑ YES-Select Scope: ❑ Service ❑ Feeder ❑ Circuits-#: ❑ Complete Re-wire. LOW VOLTAGE WORK? ❑✓ NO ❑YES-#of Devices: 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: I✓I NO ❑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: ❑✓ NO ❑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 licensinglee fcation requirement. CONTACT INFORMATION ( OWNER NAME: Columbia Debt RecoveryColumbia Debt Recovery TENANT BUSINESS NAME(If Commercial). OWNER MAILING ADDRESS: STREET 906 SE Everett Way CITY Everett STATE WA ZIP 98208 OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: Mastercraft Electric, Inc. CONTRACTOR ADDRESS: sTREET206 Frontage Rd N, Suite A2 CITY Pacific STATE WA zIP 98408 CONTRACTOR PHONE:253-737-4367 CONTRACTOR EMAIL:Carlosc@Master CONTRACTOR LIC.#(REQUIRED):MASTEEI127B8 CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 055704 ! PRIMARY CONTACT: ❑OWNER ['CONTRACTOR ['OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:253-737-4367 Carlos CaStaneda CONTACT EMAIL:Carlosc@mastercraftinc.com AGREEMENT:1 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 wi(I 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 regiltting 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 wit1'the Stat Instruction Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only / /! PERMIT#: E Owner/Authorizeq Agent Signature Date (Revised 1/11/2019) Page 1-Application