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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> EVERETT 3200 CEDAR STREET, EVERETT,WA 98201 <br /> WASHINGTON (P)425-257-8810 1 (E)PermitServices@everettwa.gov I www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS:535 View Ridge Dr BUILDING AREA: r;r sq ft <br /> PROJECT TYPE: ❑✓ NEW CONSTRUCTION ❑ADDITION ❑TENANT IMPROVMENT ❑REMODEL <br /> BUILDING USE: ❑✓ SFR [—]TOWNHOUSE ❑ DUPLEX ❑ADU ❑MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL <br /> ELECTRICAL APPLICATION INFORMATION & DESCRIPTION OF WORK <br /> CONTRACT PRICE OF WORK: $28000 ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIBE SCOPE OF WORK: <br /> THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) <br /> LINE VOLTAGE WORK? ✓❑ NO ❑YES-Select Scope: ❑Service <br /> ❑Feeder ❑Circuits: ❑Complete Re-wire <br /> LOW VOLTAGE WORK? ❑ NO El YES-#of Devices:4 <br /> SELECT SCOPE(REQUIRED): 2 Data ❑Intercom 0 Thermostat ❑✓ Audio ❑Secure Access 71 Security System <br /> ❑✓ Fire Alarm-Installations under this permit only include electrical wiring rough-in of the system.An <br /> additional Fire Alarm Permit is required for review of device location and installation approval. <br /> ❑Other(List All): <br /> CODE COMPLIANCE <br /> IS THIS PERMIT EDUCATION, INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: ✓ NO L1 YES--See Below& Pg. 2 <br /> ❑ By checking this box, I am stating that 1 have read and understand all of WAC 296.46B-900,selected the specific reason on page <br /> 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 <br /> See Page 2 require Plan Review. <br /> ARE YOU AN OWNER PERFORMING WORK AS THE CONTRACTOR WITHOUT ELECTRICAL LICENSURE: ✓ NO ES-See Below&Pg. <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: J & S Development LLC TENANT BUSINESS NAME(if Commercial): <br /> OWNER MAILING ADDRESS: STREET 22621 57th Ave SE CITY Bothell STATE WA Y\f�/A ZII,98021 <br /> OWNER PHONE: 425-870-8922 OWNER EMAIL: bstrootman@msn.com <br /> CONTRACTOR NAME: Sharp Electric LLC <br /> CONTRACTOR ADDRESS: STREET6011 Fleming St /� <br /> CITY Everett STATE WA 7_IP 98203 <br /> CONTRACTOR PHONE:425-789-1719 CONTRACTOR EMAIL: <br /> CONTRACTOR LIC.#(REQUIRED):SHARPEL863DS ICITY OF EVERETT BUSINESS LIC.#(REQUIRED): <br /> PRIMARY CONTACT: DOWNER ❑CONTRACTOR ❑✓ OTHER (Please Specify) Civil eng-Project PM <br /> CONTACT NAME: CONTACT PHONE:425-773-9567 <br /> Bob Nehring,PE Sound Design Eng CONTACT EMAIL: <br /> bob.sdeng@gmail.com <br /> 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 <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 <br /> or 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 /> cornpry wren III&31ale contractors Law 16.21 tecw and 2se.2oo WAG. city of Everett Official Use Only <br /> PERMIT#: <br /> fh tv- N'Avv' _ 6/26/2023 JE ::1 <br /> Owner Aut orized Agent Signature Date (Revised 41512022) Page 1-Application <br />