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ELECTRICAL PMIT & FIRE ALARM POZMIT APPLICATION
<br /> • CITY OF EVERETT PERMIT SERVICES
<br /> 3200 CEDAR STREET, EVERETT,WA 98201
<br /> (P)425-257-8810 I FAX 425-257-8857 I (E)everetteps@everettwa.gov I www.everettwa.gov/permits
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<br /> PROJECT ADDRESS: 9001 Airport Road Everett,WA 98204
<br /> PROJECT TYPE: UNEW CONSTRUCTION ADDITION If211 TENANT IMPROVMENT IIIREMODEL
<br /> BUILDING USE: [SFR 0 TOWNHOUSE 1 DUPLEX �DU 0 MULTI-FAMILY-#OF UNITS: 1COMMERCIAL
<br /> BUILDING AREA: 16,000 sq ft
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<br /> CONTRACT PRICE OF WORK:$ ` ASSOCIATED BUILDING PERMIT#(if applicable): NA
<br /> IS THIS LOW VOLTAGE WORK? 0 NO 0 YES-#OF DEVICES:
<br /> IS THIS A FIRE ALARM PERMIT? D O 0 YES-Plans required for review(Both Electrical and Fire Department inspections are required)
<br /> DESCRIPTION OF WORK: Installing connections for CNC machines and a lathe to an existing panel.
<br /> THIS SECTION APPLIES TO ALL EDUCATION,INSITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES:
<br /> roiBy 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
<br /> of this application(see next page),AND Plan Review is NOT required because I meet all of the following sub sections that do not
<br /> See Page 2 require Plan Review.
<br /> ATTENTION OWNERS:THIS SECTION IS FOR OWNERS PERFORMING WORK AS THE CONTRACTOR WITHOUT ELECTRICAL LICENSURE:
<br /> I u l 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.
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<br /> OWNER NAME: Mukilteo School District TENANT BUSINESS NAME(If Commercial): SNO-ISLE Skills Center
<br /> OWNER MAILING ADDRESS: STREET 9401 Sharon Drive
<br /> CITY Everett STATE WA zip 98204
<br /> OWNER PHONE: (425)356-1274 OWNER EMAIL:
<br /> CONTRACTOR NAME: Bonner Electric
<br /> CONTRACTOR ADDRESS: STREET 1419 Dike Road
<br /> _ .. •-r onSTATE WA ZIP
<br /> 360-8•• ' 40
<br /> CONTRACTOR PHONE: 'CONTRACTO' EMAIL:
<br /> CONTRACTOR LIC.#(REQ -ED): ) CCt O IStITY OF EVERETT BUSINESS LIC.#(REQUIR D): 5 Rfi (:) 1
<br /> Engineer
<br /> PRIMARY CONTACT: ■0.WNER ❑ ONTRACTOF OTHER(Please Specify) En 9
<br /> CONTACT NAME: CONTACT PHONE: 253-922-0446
<br /> Ben Hedin CONTACT EMAIL: ben.hedin@bceengineers.com
<br /> AGREEMENT:I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions 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 /> Ben Hedin 12/4/18 e (w, -.0(lit
<br /> Owner/Authorized Agent Signature Date (Revised 10/30/2018) Pege-4-erf3—
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