10330 EVERGREEN WAY GLINT CAR WASH 2023-04-10

CTRICAL PERMIT APPL&TION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P) 425-257-8810 1 FAX 425-257-8857 1 (E) everetteps@everettwa.gov I www.everettwa.gov/permits 3 D PROJECT SITE INFORMATION PROJECT ADDRESS: _ - �'F e Cal t BUILDING AREA: sq ft PROJECT TYPE: NEW CONSTRUCTION ❑ ADDITION ❑ TENANT IMPROVMENT ❑ REMODEL BUILDING USE: ❑ SFR ❑ TOWNHOUSE ❑ DUPLEX ❑ ADU ❑ MULTI -FAMILY - # OF UNITS: COMMERCIAL ELECTRICAL APPLICATION INFORMATION & DESCRIPTION OF WORK CONTRACT PRICE OF WORK: $ V . ASSOCIATED BUILDING PERMIT # (if applicable) - DESCRIBE SCOPE OF WORK: J j 5fo ; / ,S (_ T Le,T ZeJr 0- e-" 1 oil ems! t` C�Pt-'. /%�� —r s Scf �a , i F ti 7'_ L 41 fZT11 1,0111 THIS INSTALLATION INCLUDES THE FOL OWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? P'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): If- CODE COMPLIANCE IS THIS PERMIT EDUCATION, INSTITUTIONAL, HEALTH AND/OR PERSONAL CARE FACILITIES: i NO D YES -- See Below & Pg. 2 ❑ By checking this box, I am stating that I have read and understand all of WAC 296-4613-900, 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: FNO nYES -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 F� without the proper electrical licensing and certification, or exemption. By checking this box, l 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 // . �CIL�- OWNER NAME:i X VIV I �yl J Al' / S 'UnI TENANT BUSINESS NAME (If Commercial): OWNER MAILING ADDRESS: STREET 0 CITY STATE ZIP 1 3 OWNER PHONE: �5 S �� U v OWNER EMAIL: ►; )'O, C7Gl CONTRACTOR NAME: S �C• CONTRACTOR ADDRESS: STREET ,S-/5- R FRee CV CITY J STATE C(,7 ZIP 9 CONTRACTOR PHONE: 6 �% - - g q� CONTRACTOR EMAIL iO'S k%' , CONTRACTOR LIC. #(REQUIRED): G !J M Q 7 g CITY OF EVERETT BUSINESS LIC. #(REQUIRED): PRIMARY CONTACT: ]OWNER 2CONTRACTOR ❑OTHER (Please Specify) CONTACT NAME: lie CONTACT PHONE: 0 CONTACT EMAIL: 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 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 / am 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 o �- Owner/Authorized Agen Signature Date PERMIT #- E q Page 1-Application