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Online Permit Request Form Revision 2.4 <br /> Prime Information <br /> Requesting Employee:I Ingrid Miller Submitted Date: 1/26/2024 <br /> Job Name: Everett Station Required Date: 1/30/2024 <br /> Job Address:13201 Smith Ave Job Number:15002912 <br /> City: Everett Zip:198201 <br /> Work Location: (Garage/Roof/3rd Floor) <br /> Parcel Number: Contact Name:I Erin Grey <br /> Property Owner: Contact Phone: 425-429-1662 <br /> Description: Provide and install (2) Category 6 to (2) PIM's sign locations. Prime Electric contact for permit is Ingrid <br /> Miller Phone: (425)864-5770 Email: imiller@primee.com <br /> Total Electrical Value $ 10,460 <br /> Job Information <br /> # of Connections T # of Circuts Grounding <br /> Light Fixtures Commercial Dimmers Ufer Ground Including ❑Y ❑N <br /> Track Lighting Non-Electric Furnace <br /> Switches 15-25a Dedicated Circuit Fire Alarm <br /> Receptacles 30-50a Dedicated Circuit Phone and Data Systems <br /> Multi-Outlet Assemblies Floodlights(Parking Lot/Pole Control Units <br /> Smoke Detectors Sign Circuts Devices El <br /> Service Installation Feeders Low Voltage <br /> Amperage Qty Amperage Voltage Qty Phone and Data Systems <br /> Control Units <br /> Devices 2 <br /> Low Voltage Systems <br /> Control Units <br /> Devices E] <br /> Transformers Motors Electric Heat <br /> Amperage Qty Horsepower Qty Kilowatts Qty <br /> Renewable Energy Systems EV Charging Stations Subs Covered by Permit <br /> System Size Qty Type Amperage Qty <br /> E�_ EEd E=1 E] I <br /> Notes: <br /> Permit # <br />