515 SE EVERETT MALL WAY STARBUCKS 2019-03-14

ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES '41PW:41 '441g943200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps©everettwa.gov I www.everettwa.govipermits . , PROJECTSITEINFORMATION_ PROJECT ADDRESS: 515 SE Everett Mall Way BUILDING AREA: 0141 sq ft PROJECT TYPE: El NEW CONSTRUCTION El ADDITION El TENANT IMPROVMENT El REMODEL BUILDING USE: El SFR CI TOWNHOUSE El DUPLEX El ADU El MULTI-FAMILY #OF UNITS: E COMMERCIAL - ELECTRICAL APPLICATIONINFORMATION & DESCRIPTIOtf0F.W9RIC.' - ,-) T) CONTRACT PRICE OF WORK: $ T&M r-s,6,) LASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: Add circuit for fire alarm radio. THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? El NO El YES-Select Scope: El Service 0 Feeder El Circuits-#: El Complete Re-wire LOW VOLTAGE WORK? El NO El YES-#of Devices: SELECT SCOPE(REQUIRED): El Data E] Intercom El Thermostat CI Audio El Secure Access CI Security System 0 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. El Other(List All): • CODE COMPLIANCE IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: E NO El YES--See Below&Pg.2 By checking this box, I am stating that I have read and understand all of WAC 296-46B-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 EYES-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 See page 3 signed the AFFIDAVIT on page 3 of this application to receive an exemption from this licensing/certification requirement, ‘- • CONTACT INFORMATION OWNER NAME: &j.reat- ree,, pic2a 18 LaCTENANT BUSINESS NAME(If Commercial) Wa 11/9,4eKciefi OWNER MAILING ADDRESS: STREET /2-'1+11 t/!/7 ra 13 ivd CITY cSYU4Ii2STATE ell ZIP q &foci OWNER PHONE: ig- 505- i777 OWNER EMA : CONTRACTOR NAME: Rhema Electric LLC CONTRACTOR ADDRESS: STREET 628 S Spruce St crry Burlington STATE WA zip 98233 CONTRACTOR PHONE:360-770-8115 CONTRACTOR EMAIL:marks@rhemaelectric.com CONTRACTOR LIC.#(REQuiRED):RHEMAEL940DH CITY OF EVERETT BUSINESS LIC.#(REQUIRED):45783 PRIMARY CONTACT: IJOVVNER • • NTRACTOR ii%7•4 HER(Please Specify) i&i,i/kd CONTACT NAME: CONTACT PHONE: ;3(.61,0--7'301 15 Mark Sfefieff CONTACT EMAIL: fr arks& rheirit„ej..v ofr, ,cifym •AGRgE114007.1)1ereby cc ify that I have read and examined this application and know the same to be true and correct. All provisions of laws end 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 I am authorized by the owner of this property to perform are work for which appl cation is made and) compfy with the Stale Contractors Law 18.27 RC Wand 298.200 WAC. City of Everett Official Use Only (1 , /) hi PERMIT#: E 101 (), -1 tb( Owner/Authorized Agent Signatu Date (Revised 1/11/2019)