505 SE EVERETT MALL WAY I LOVE KICKBOXING 2019-03-21

ELECTRICAL PERMIT & FIRE ALARM PEIT APPLICATION CITY OF EVERETT PERMIT SERVICES _ 3200 CEDAR STREET, EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 I (E)everetteps@everettwa,gov I www.everettwa.gov/permits PROSECT #TE JNFORINNAATIOt PROJECT ADDRESS:505 SE Everett Mall Way PROJECT TYPE:MEW CONSTRUCTION ❑❑ADDITION ® ENANT IMPROVMENT EIREMODEL BUILDING USE: ❑]SFR 0 TOWNHOUSE IT:TIDUPLEX 0 DU 0 MULTI-FAMILY-#OF UNITS: ❑ COMMERCIAL BUILDING AREA: 3480 sq ft ELECTRICAL APPLICATIONINFOR,MATIION; i - CONTRACT PRICE OF WORK:$19,500 ASSOCIATED BUILDING PERMIT#(if applicable): IS THIS LOW VOLTAGE WORK? m NO ❑YES-#OF DEVICES: IS THIS A FIRE ALARM PERMIT? ® NO 0 YES-Plans required for review(Both Electrical and Fire Department inspections are required) DESCRIPTION OF WORK & CODE COMPLIANCE DESCRIPTION OF WORK: Tenant improvements of existing spaces. Combine studios#3 &4 to make one space for kick boxing studio and retail sales THIS SECTION APPLIES TO ALL EDUCATION,INSITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: yv IA [pi 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. ATTENTION OWNERS:THIS SECTION IS FOR OWNERS PERFORMING WORK AS THE CONTRACTOR WITHOUT ELECTRICAL LICENSURE: I I Pursuant to RCW 19.28.261,propertyowners 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 1 have completed and signed the See Page 3 AFFIDAVIT on page 3 of this application to receive an exemption from this licensing/certification requirement. CONTACT INFORMATION OWNER NAME: Udit Saxena TENANT BUSINESS NAME(If Commercial): I Love Kickboxing OWNER MAILING ADDRESS: STREET 17126 NE 83rd CITY Redmond STATE WA ZIP 98052 OWNER PHONE: 425-503-1908 OWNER EMAIL: udit_sexena@hotmail.com CONTRACTOR NAME: Main Street Electric, Inc CONTRACTOR ADDRESS: STREET PO Box 1856 CITY Edmonds STATE WA ZIP 98020 CONTRACTOR PHONE:425-775-6246 CONTRACTOR EMAIL:Jeff@mainstreet-eleCtric.com CONTRACTOR LIC.#(REQUIRED):MAI NSE1021DK CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 054879 PRIMARY CONTACT: 'DOWNER IONTRACTOR 110THER(Please Specify) CONTACT NAME: CONTACT PHONE: 206-818-1995 Jeff Humann CONTACT EMAIL: jeff@mainstreet-electric.com AGREEMENT:I hereby certify that/have 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 I am authorized by the owner of this property to perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200 WAC. - City of Everett Official Use Only PERMIT# � 1/11 Ilt k,„..0‘,_,„,...------- if/ cit i g iq (f- 0(a9 l Ow thorized Agent Signature Date (Revised 10/30/2018) Page 1 of 3