1525 75TH ST SW COMCAST 2022-07-14

Nom num EI CTRICAL PERMIT APPLI9TION EVERETT 32 CITY OF EVERETT PERMIT SERVICES 00 CEDAR STREET,EVERETT,WA 98201 WASHINGTON (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 1525 75th ST SW BUILDING AREA: sq ft PROJECT TYPE: ❑NEW CONSTRUCTION El ADDITION 0 TENANT IMPROVMENT El REMODEL BUILDING USE: D SFR ❑TOWNHOUSE ❑DUPLEX ❑ADU ❑MULTI-FAMILY-#OF UNITS: ✓❑COMMERCIAL ELECTRICAL APPLICATION INFORMATION & DESCRIPTION OF WORK CONTRACT PRICE OF WORK:$ 2700 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: Install modular furniture floor 1. Connected to existing circuits provided by others. THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE:(SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ❑NO ❑✓ YES-Select Scope: D Service ❑ Feeder 0 Circuits-#:20 ❑Complete Re-wire LOW VOLTAGE WORK? El NO ❑YES-#of Devices: SELECT SCOPE(REQUIRED): El Data El Intercom ❑Thermostat ❑Audio El 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 ANDIOR PERSONAL CARE FACILITIES: El NO D YES—See Below&Pg.2 ❑ By checking this box, I am stating that I have read and understand all of WAC 296.46E-800,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. CONTACT INFORMATION OWNER NAME:Johnson Properties LLC TENANT BUSINESS NAME(If Commercial):Comcast Service Center OWNER MAILING ADDRESS: STREET PO box 5253 CITY STATE STATE WA zip 98206 OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: SES, Inc CONTRACTOR ADDRESS: STREET1402 Auburn Way N #371 aT,,Auburn STATE WA ZIP 98002 CONTRACTOR PHONE:206-714-3686 CONTRACTOR EMAIL:awapaho@comcast.net CONTRACTOR LIC.#(REQUIRED):SESIN**990RA CITY OF EVERETT BUSINESS LIC.#(REQUIRED):042778 PRIMARY CONTACT: DOWNER D✓CONTRACTOR ['OTHER(Please Specify) CONTACT NAME:Tony Arbicor CONTACT PHONE:206-714-3686 CONTACT EMAIL:aWapaho@comcast.net AGREEMENT:l 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 lam 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#: 9-10-2021 E 210 -1)---1 VJ Owner/Authorize gent Signature Date (Revised 1/11/2019) Page 1-Application