6101 ASSOCIATED BLVD ELECTRIC MIRROR 2022-07-29

ELECTRICAL PIKMIT & FIRE ALARM PEMIT APPLICATION CITY OF EVERETT PERMIT SERVICES 477- 3200 CEDAR STREET, EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 I (E)everetteps©everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 6101 ASSOCOATED BLVD STE 101 PROJECT TYPE: 0 NEW CONSTRUCTION ❑ADDITION ❑TENANT IMPROVMENT El REMODEL BUILDING USE: ❑SFR El TOWNHOUSE El DUPLEX ❑ADU ❑ MULTI-FAMILY-#OF UNITS: El COMMERCIAL BUILDING AREA: sq ft ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK:$4500 ASSOCIATED BUILDING PERMIT#(if applicable): IS THIS LOW VOLTAGE WORK? ❑ NO ❑YES-#OF DEVICES: IS THIS A FIRE ALARM PERMIT? ❑ NO ❑ YES-Plans required for review(Both Electrical and Fire Department inspections are required) DESCRIPTION OF WORK & CODE COMPLIANCE DESCRIPTION OF WORK: NADA TURRET PUNCH E L.f i 7 L &) 1 1{ _J l C IS THIS P MIT EDUCATION,INSITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: ✓0 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:LINO DYES-See Below&Pg.3 I I 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 signed the See Page 3 AFFIDAVIT on page 3 of this application to receive an exemption from this licensing/certification requirement. CONTACT INFORMATION OWNER NAME:ELECTRIC MIRROR TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: sTREET6101 ASSOCIATED BLVD STE 101 CITY EVERETT STATE WA ZIP 98203 OWNER PHONE:425.381.1406 OWNER EMAIL: CONTRACTOR NAME:EYLANDER SALES & SERVICE CONTRACTOR ADDRESS: STREET3601 EVERETT AVE cry EVERETT STATE WA ZIP 98201 CONTRACTOR PHONE:425.259.2161 CONTRACTOR EMAIL: CONTRACTOR LIC.#(REQUIRED):EYLANSS142LP CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 016363 PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR 7I OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:425.231.2275 J O H N d a-e If CONTACT EMAIL: 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/comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only PERMIT# A �gk2a — tS '4 9 9 O er/Authorized A ent Signature Date (Revised 11/5/2018) Page 1-Application