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Online Permit Request Form Revision2.4 <br /> Prime Information <br /> Requesting Employee: Steve Lovell Submitted Date:13.25.2024 <br /> Job Name: Madison House Required Date: 4.2.2024 <br /> Job Address:1528 Madison St Job Number: 1019577 <br /> City: Everett Zip: 98203 <br /> Work Location: back of house (Garage/Roof/3rd Floor) <br /> Parcel Number: I Contact Name: Mike Kinney <br /> Property Owner: City of Everett Contact Phone:1425 429-4654 <br /> Description: Revise to add fire alarm, convert back bedroom into (2) bedrooms, change exhaust fans in restrooms and <br /> some light fixtures <br /> Total Electrical Value $ 16,895 <br /> Job Information <br /> # of Connections #of Circuts Grounding <br /> Light Fixtures 8 Commercial Dimmers Ufer Ground Including ❑Y ❑N <br /> Track Lighting Non-Electric Furnace <br /> Switches 3 15-25a Dedicated Circuit 2 Fire Alarm <br /> Receptacles 9 30-50a Dedicated Circuit Phone and Data Systems <br /> Multi-Outlet Assemblies Floodlights(Parking Lot/Pole Control Units B <br /> Smoke Detectors 4 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 /> LE <br /> Renewable Energy Systems EV Charging Stations Subs Covered by Permit <br /> System Size Qty Type Amperage Qty <br /> Notes: <br /> Permit # <br />