1727 E MARINE VIEW DR SERVICE MASTER 2019-03-28

ELECTRICAL PERMIT APPLICA 1ION OJLTCITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 (P)425-257-8810 1 FAX 425-257-8857 1(E)everetteps@everettwa.goy l www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 1 727 E Marine View Dr. BUILDING AREA: sq ft PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ADDITION ❑TENANT IMPROVMENT ✓❑ REMODEL BUILDING USE: ❑ SFR ❑ TOWNHOUSE ❑ DUPLEX ❑ADU ❑ MULTI-FAMILY-#OF UNITS: ✓❑ COMMERCIAL ELECTRICS 11 MOLE,....�. .;..,.RMATIO+ 'k CONTRACT PRICE OF WORK: $ 500 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: Install one quad receptacle and one duplex recepacle from existing circuits THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ❑ NO ❑✓ YES-Select Scope: ❑ Service ❑ Feeder ❑ Circuits-#: 1 ❑ Complete Re-wire LOW VOLTAGE WORK? ❑ NO ❑YES-#of Devices: SELECT SCOPE(REQUIRED) ❑ Data ❑ Intercom ❑Thermostat ❑Audio El Secure Access ❑ Security System El 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. ❑Other(List All): CODE COMPLIANCE - •Vie:-STAR'. IS THIS PERMIT EDUCATION, INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: El NO • 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: L&M Services Inc. DBA SOS TENANT BUSINESS NAME(If Commercial): Service Master OWNER MAILING ADDRESS: STREET 1727 E Marine View Dr CITY Everett STATE \NA ZIP 98201 OWNER PHONE:425-457-9877 OWNER EMAIL: CONTRACTOR NAME: Titan Electric Inc. CONTRACTOR ADDRESS: STREET 12828 Northup Way, Suite 205 CITY Bellevue STATE v Y,/�/ A Zip 98005 CONTRACTOR PHONE:206.633.2811 CONTRACTOR EMAIL:Permits@titanelectric.net CONTRACTOR LIC.#(REQUIRED):TITANE19630B CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 51191 PRIMARY CONTACT: ❑OWNER ❑✓CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:206.633.2811 Linda Anderson CONTACT EMAIL:permits@titanelectric.net 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/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#: I ` /� Digksr-I tl by L ntla"e'erson C J/ a` ' tO t. C I v yvI V ©N±C-US E I Caa�llanelectrc nel 0 Tlan Electnc Company lnc. Linda Anderson DeeLI2EaAC 107 Dee zotsozm mzssaoeoo Owner/Authorized Agent Signature Date (Revised 1/11/2019) Page 1-Application