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Online Permit Request Form Revision2.4 <br /> Prime Information <br /> Requesting Employee: George Harding Submitted Date: 7/3/24 <br /> Job Name: Evercharge Chase Bank I Required Date: 7/8/24 <br /> Job Address: 1517 132nd St SE Job Number:16007800 <br /> City: Everett Zip: 98208 <br /> Work Location: Chase Bank (Garage/Roof/3rd Floor) <br /> Parcel Number: Contact Name:lGeorge Harding <br /> Property Owner: Chase Bank Contact Phone:1425.457.0479 <br /> Description: Pull circuits for EV charging station. One pole with dual head charging. Tie into exisitng service. <br /> Total Electrical Value $ 12 0000 <br /> Job Information <br /> # of Connections #of Circuts Groundinq <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 1 Phone and Data Systems <br /> Multi-Outlet Assemblies Floodlights(Parking Lot/Pole Control Units B <br /> Smoke Detectors Sign Circuts Devices <br /> Service Installation Feeders Low Voltage <br /> Amperage Qty Amperage Voltage Qty Phone and Data Systems <br /> Control Units B <br /> Devices <br /> Low Voltage Systems <br /> Control Units <br /> Devices El <br /> Transformers Motors Electric Heat <br /> Amperage Qty Horsepower Qty Kilowatts Qty <br /> Renewable Energy Systems EV Charginq Stations Subs Covered by Permit <br /> System Size Qty Type Amperage Qty <br /> Evercharge 50A 1 <br /> Notes: <br /> Permit # <br />