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4253223792 Main Fax 194:43 a.m. 12-07-2018 1 /3
<br /> ELECTRICAL PERMIT & FIRE ALARM PERMIT APPLICATION
<br /> CITY OF EVERETT PERMIT SERVICES
<br /> 3200 CEDAR STREET,EVERETT,WA 98201
<br /> (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps@everettwa.gov I www.everettwa.gov/permits
<br /> egglatMagagnaleMOVP,004,00rt SITE_INFORMATION' :'
<br /> PROJECT ADDRESS: 1010 SE Everett Mall Way, Everett, WA 98208
<br /> PROJECT TYPE:f NEW CONSTRUCTION ■Q ADDITION Cil ENANT IMPROVMENT nREMODEL
<br /> BUILDING USE: ❑1SFR 0 TOWNHOUSE 0 ■UPLEX 0 DU 0 MULTI-FAMILY-#OF UNITS: COMMERCIAL
<br /> BUILDING AREA: 4942 sq ft
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<br /> CONTRACT PRICE OF WORK:$81000.00 ASSOCIATED BUILDING PERMIT#(if applicable):
<br /> IS THIS LOW VOLTAGE WORK? ❑ NO QI YES-#OF DEVICES: 6
<br /> IS THiS A FIRE ALARM PERMIT? ❑ NO ❑ YES-Plans required for review(Both Electrical and Fire Department inspections are required)
<br /> .. . ..... .............. .. ...................DESCRIPTIO O ,�'a:
<br /> „ . .<_..�... ., .,..., N F,WORK,B:CODE ;:.::::
<br /> DESCRIPTION OF WORK: Tenant improvement on existing office space.
<br /> THIS SECTION APPLIES T• • .L EDUCATIO.,INSITUTION• HEALTH AN• •R PERSON• ARE FACILIT S:
<br /> checking is bo I am star gt -t I have re.d a • understasped all •f WAC 2'•-46: 900,seta• ed t'e reas• o .a e 2
<br /> Lill his ap. cation(• -e nex .age), •ND PI. Revie+ is NO 'require, beca -e I mee -Ii of e followi :e s ; sections t' do no
<br /> Sr2 req • - • an Review.
<br /> AENTION OWNERS:THIS SECTION IS FOR OWNERS PERFORMING WORK AS THE CONTRACTOR WiTHOUT ELECTRICAL LICENSURE:
<br /> ® Pursuant to RCW 19.28.261,property owners and leaseholders cannot perform electrical work on buildings for rent,sale,or lease without
<br /> the proper electrical licensing and certification,or exemption.By checking this box,I am stating that I have completed and signed the
<br /> See Page 3 AFFIDAVIT on page 3 of this application to receive an exemption from this licensing/certification requirement.
<br /> OWNER NAME: Department of Veteran Affairs TENANT BUSINESS NAME(If Commercial):
<br /> OWNER MAILING ADDRESS: sTneeT 1010 SE Everett Mall Way
<br /> CITY Everett STATE WA zip 98208
<br /> OWNER PHONE: OWNER EMAIL:
<br /> CONTRACTOR NAME: West Coast Electrical Services •
<br /> CONTRACTOR ADDRESS: STREET 12527 Mukilteo Speedway,Suite 103
<br /> cmr Lynnwood STATE WA zip 98087
<br /> CONTRACTOR PHONE: 425-322-3189 CONTRACTOR EMAIL: kyle@wcelectrics.cam
<br /> CONTRACTOR LIC.#(REQUIRED):WESTCCE897PQ CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 053544
<br /> PRIMARY CONTACT: PIOWNER CONTRACTOR EIOTHER(Please Specify)
<br /> CONTACT NAME: CONTACT PHONE: 425-322-3189
<br /> Kyle Adams CONTACT EMAIL: kyleWcelectriCs.com
<br /> AGREEMENT:t hereby certify that/have read and examined this application and know the same to be true and correct. All previsions of laws and ordinances
<br /> 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
<br /> 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
<br /> work for which application is made and 1 comply with the State Contractors Law 18.27 RCW and 296.200 WAC.
<br /> City of Everett Official Use Only
<br /> PERMIT#
<br /> a/1(5( d \9)1\2— e03
<br /> Own' iAuthorized Agent Signature atRevised 10/302018
<br /> ( ) Page 1 of 3-)
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