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ELECTRICAL PERMIT & FIRE ALARM PE!MIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 1 FAX 425-257-8857 1 (E) everetteps@everettwa.gov 1 www.everettwa.gov/permits <br /> 477- <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: 1722 W Marine View Drive, Everett <br /> PROJECT TYPE: ❑ NEW CONSTRUCTION ❑❑ADDITION 0 TENANT IMPROVMENT El REMODEL <br /> BUILDING USE: 0 SFR 0 TOWNHOUSE 0 DUPLEX 0 ADU 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> BUILDING AREA: 2,200 sq ft <br /> ELECTRICAL APPLICATION INFORMAT + , <br /> CONTRACT PRICE OF WORK: $ 800.00 ASSOCIATED BUILDING PERMIT#(if applicable): B1809-006 <br /> IS THIS LOW VOLTAGE WORK? 0 NO 0 YES-#OF DEVICES: 2 <br /> IS THIS A FIRE ALARM PERMIT? 0 NO 0 YES-Plans required for review(Both Electrical and Fire Department inspections are required) <br /> DESCRIPTION OF WORK & CODE COMPLIANCE <br /> DESCRIPTION OF WORK: Installation of 2 devices. <br /> THIS SECTION APPLIES TO ALL EDUCATION, INSITUTIONAL, HEALTH AND/OR PERSONAL CARE FACILITIES: <br /> laBy 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 /> ® 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 /> CONTACT INFORMATION <br /> OWNER NAME: Anthony's Woodfire Grill TENANT BUSINESS NAME(If Commercial): Anthony's Woodfire Grill <br /> OWNER MAILING ADDRESS: STREET 1722 W Marine View Drive <br /> CITY Everett STATE WA ZIP 98201 <br /> OWNER PHONE: 425.258.4000 OWNER EMAIL: <br /> CONTRACTOR NAME: R-C True Line Corp. <br /> CONTRACTOR ADDRESS: STREET 15321 105th Ave CT E <br /> cim, Puyallup STATE WA L1P 98374 <br /> CONTRACTOR PHONE: 253.846.1562 CONTRACTOR EMAIL: NICk q©rCtruellne.COITI <br /> CONTRACTOR LIC.#(REQUIRED): EC RCTRULC038QG CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 35133 <br /> PRIMARY CONTACT: ❑ OWNER [31"CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 253.377.7504 <br /> Nick Rau CONTACT EMAIL: Nick@rotrueline.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 I comply with the State Contractors Law 18.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> PERMIT# <br /> Kevin Rau 12/3/2018 + I. 2 - C 2—O <br /> Owner/Authorized Agent Signature Date (Revised 10/30/2018) <br />