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1 - <br /> Ellt• <br /> CTRICAL PERMIT APPLI TION <br /> EVERETT CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> WASHINGTON (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov i www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: 1 327 1 1 2TH ST SE STE C BUILDING AREA: 868 sq ft <br /> PROJECT TYPE: ❑✓ NEW CONSTRUCTION El ADDITION TENANT IMPROVMENT El REMODEL <br /> BUILDING USE: ❑ SFR El TOWNHOUSE ❑ DUPLEX ❑ ADU I-J MULTI-FAMILY-#OF UNITS: ✓❑ COMMERCIAL <br /> ELECTRICAL APPLICATION INFORMATION & DESCRIPTION OF WORK <br /> CONTRACT PRICE OF WORK:$ $10,368.00 ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIBE SCOPE OF WORK: <br /> Illuminated exterior channel letter wall sign <br /> THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) <br /> LINE VOLTAGE WORK? 7 NO ❑ YES-Select Scope: ❑Service El Feeder ❑ Circuits-#: ❑ Complete Re-wire <br /> LOW VOLTAGE WORK? El NO ❑✓ YES-#of Devices: 1 <br /> SELECT SCOPE(REQUIRED): ❑ Data El Intercom El Thermostat ❑Audio ❑ Secure Access ❑ Security System <br /> ❑ Fire Alarm- Installations under this permit only include electrical wiring rough-in of the system.An additional <br /> Fire Alarm Permit is required for review of device location and installation approval. <br /> ❑✓ Other(List All):LED Sign lighting <br /> CODE COMPLIANCE <br /> IS THIS PERMIT EDUCATION, INSTITUTIONAL, HEALTH AND/OR PERSONAL CARE FACILITIES: ❑✓ NO -I YES--See Below&Pg. 2 <br /> 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 <br /> of this application(see next page),AND Plan Review is NOT required because I meet all of the following sub sections that do not <br /> See Page 2 require Plan Review. DYES ARE YOU AN OWNER PERFORMING WORK AS THE CONTRACTOR WITHOUT ELECTRICAL LICENSURE: ❑✓ NO DYES-See Below&Pg.3 <br /> Pursuant to RCW 19.28.261, property owners and leaseholders cannot perform electrical work on buildings for rent,sale, or lease <br /> without the proper electrical licensing and certification, or exemption. By checking this box, I am stating that I have completed and <br /> See Page 3 signed the AFFIDAVIT on page 3 of this application to receive an exemption from this licensing/certification requirement. <br /> CONTACT INFORMATION <br /> OWNER NAME: Claire Bruining TENANT BUSINESS NAME(If Commercial): Stuffington's Ceramics & More <br /> OWNER MAILING ADDRESS: STREET 1327 112th St SE, STE C ciTv Everett STATE v�'`/�/ <br /> A zIF 98208 <br /> OWNER PHONE:(425) 337-6306 OWNER EMAIL:stuffingtonsemporium@gmail.com <br /> CONTRACTOR NAME: Advanced Signs LLC <br /> CONTRACTOR ADDRESS: STREET 37th St NW <br /> CITY Auburn STATE WA ZIP 98001 <br /> CONTRACTOR PHONE:253-981-3454 CONTRACTOR EMAIL:darrin.jones@pugetsoundsigns.com <br /> CONTRACTOR LIC.#(REQUIRED):ADVANSL923DP CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 97 <br /> PRIMARY CONTACT: DOWNER ❑✓CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:253-981-3454 <br /> Darri n Jones CONTACT EMAIL:darrin.jones@pugetsoundsigns.com <br /> AGREEMENT:1 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 <br /> 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 <br /> 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 I <br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only <br /> PERMIT#: <br /> Damn Jones 4/4/22 E 2i O _ OH () <br /> Owner/Authorized Agent Signature Date (Revised 1/11/2019) Page 1-Application <br />