701 75TH ST SE BLDG 1 SHORESIDE VILLAGE 2025-05-16

rai ELECTRICAL PERMIT APPLICATION D 'i5 E V E R E T TCITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 WASHINGTON (P)425-257-8810 I FAX 425-257-8857 I(E)evoretteps@evorettwa.gov i www.evereltwa.gov/permits • PROJECT SITE INFORMATLON PROJECT ADDRESS: 701 75th St SE unit #114 BUILDING AREA: sq ft PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ADDITION ❑TENANT IMPROVMENT 0 REMODEL BUILDING USE: ❑SFR El TOWNHOUSE ❑ DUPLEX ❑ADU 0 MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL . ...:: EI ECTR CA APPLICATION INFORMATION & DE$CRIPT$ON OF WORK CONTRACT PRICE OF WORK:$ 900.00 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: Replace existing unit panel with new 125A ML panel THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ❑ NO 0 YES-Select Scope: 0 Service El Feeder El Circuits-#: ❑ Complete Re-wire LOW VOLTAGE WORK? ❑ NO ❑ YES-#of Devices: SELECT SCOPE(REQUIRED): ❑ Data ❑ Intercom El Thermostat El Audio ❑ Secure Access El Security System ❑ 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. ❑Other(List All): a CODE COMPLIANCE IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: NO ❑ YES-- See Below&Pg.2 By checking this box, I am stating that I have read and understand all of WAC 29G-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: ENO OYES-See Below&Pg.3 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 Seepage 3 signed the AFFIDAVIT on page 3 of this application to receive an exemption from this licensing/certification requirement. CONTACT INFARIV ,k OWNER NAME: Williams Investment TENANT BUSINESS NAME(If Commercial):Shoreside Apartments OWNER MAILING ADDRESS: STREET 19801 50th Ave W ciTY Lynnwood srmE WA 98036 OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: Rhema Electric CONTRACTOR ADDRESS: S7REET628 S Spruce St ciry Burlington STATE WA z,, 98233 CONTRACTOR PHONE:360-630-0164 CONTRACTOR EMAIL:daveb@rhemaelectric CONTRACTOR LIC.#(REQUIRED):RHEMAEL9400H CITY OF EVERETT BUSINESS LIC.#(REQUIRED):45783 PRIMARY CONTACT: DOWNER ❑✓CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: '' pp 4t�.,, CONTACT PHONE:360-630-0164 Dave ve B u b e n CONTACT EMAIL:daveb@rhemaelectric.com AGREEMENT:I hereby certify that I hove 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 1 am authorized by the owner of this property to perform the work for which application is made and comply with the State Contra tors Law 15.27 ROW and 295.200 WAC. City of Everett Official Use Only I +�ww +' PERMIT#: JJ _ tel)) E I Owner/Authorized A.ent Signature Date (Revised 1/11/2019) Page 1-Application