2920 TERMINAL AVE 2023-06-23 - Laserfiche WebLink

v eb-3IP - /25 OW, ELECTRICAL PERMIT APPLICATION CITY OF EVERETT'PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 (F')425-257-8810 I FAX 425-257-8857 (E)everetteps@everettwa.gov I www.everettwa.gov/permits 1NFORMAT.Z,Z8tt PROJECT ADDRESS: 2920 Terminal Ave BUILDING ARE.A: 5000 sq ft PROJECT TYPE: El NEW CONSTRUCTION E3 ADDITION TENANT IMPROVMENT El REMODEL BUILDING USE: El SFR 0 TOWNHOUSE 0 DUPLEX El ADU El MULTI-FAMILY-#OF UNITS: 7 COMMERCIAL jiige :11WritICAVAPP4 j, #11. iIJ 0114 " CONTRACT PRICE OF WORK:$ 8,672.90 ASSOCIATED BUILDING PERMIT#(If applicable): DESCRIBE SCOPE OF WORK: Job#832564 Fiber Repair THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE:(SELECT ALL THAT APPLY) LINE VOLTAGE WORK? El NO El YES-Select Scope:D Service 0 Feeder 0 Circuits-#: El Complete Re-wire LOW VOLTAGE WORK? El NO 0 YES-#of Devices:I SELECT SCOPE(REQUIRED): ED Data 0 Intercom El Thermostat 0 Audio El Secure Access El 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. El Other(List All); .:Ati4igii4 • CPPEVIDIAPLIkI 147 ' 4 IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH ANDIOR PERSONAL CARE FACILITIES: El NO U YES—See Below&Pg.2 El 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: ONO [ YES-See Below&Pg.3 r— 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. '7 7II1II OWNER NAME: TENANT BUSINESS NAME(If Commercial):Port of Everett OWNER MAILING ADDRESS: STREET 1205 Craftsman Way, Suite 200 Everett cm, STATE WA ,,p 98201 OWNER PHONE:800-729-7678 OWNER EMAIL: CONTRACTOR NAME: EC Electric CONTRACTOR ADDRESS: STR 981 Powell Ave SW, Suite 200 EET cm Renton STATE WA zip 98057 CONTRACTOR PHONE:206-436-6086 CONTRACTOR EMAlL:amber.benedict@eppowerslife.com CONTRACTOR LIC.*REQUIRED): EC, ECZt M.*i941615A CITY OF EVERETT BUSINESS LW.#(REQUIRED •5 rra, PRIMARY CONTACT: E OWNER CONTRACTOR CIOTHER(Please Specify) CONTACT NAME: CONTACT PHONE:206-4-3fo50:86 kt) Amber CONTACT EMAIL: 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 lam 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 WAG. City of Everett Official Use Only PERMIT#: Owner/Authorized Agent Signature Date (Revised 1/11/2019) Page 1.Application