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ECTRICAL PERMIT APPLILATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERE I I WA 98201 <br /> (P)425-257-8810 FAX 425-257-8857 1(E)everetteps@everettwa.gov I www.everetIwagev/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: 6611 Associated Blvd, Everett, WA. 98203 BUILDING AREA 77'735 sq ft <br /> PROJECT TYPE: El NEW CONSTRUCTION IA ADDITION TENANT IMPROVMENT El REMODEL <br /> BUILDING USE: El SFR D TOWNHOUSE (71 DUPLEX ADU 111 MULTI-FAMILY-#OF UNITS: 117:1 COMMERCIAL <br /> ELECTRICAL APPLICATION INFORMATION & DESCRIPTION OF WORK <br /> CONTRACT PRICE OF WORK:$ 60.760-00 ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIBE SCOPE OF WORK: <br /> Remove & Replace gas detection system. <br /> THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) <br /> LINE VOLTAGE WORK? Li NO El YES-Select Scope: El Service El Feeder El Circuits-#:2 El Complete Re-wire <br /> LOW VOLTAGE WORK? NO El YES-#of Devices:21 <br /> SELECT SCOPE(REQUIRED), 1.1 Data LI Intercom [El Thermostat El Audio [Ti Secure Access n Security System • <br /> Cl Fire Alarm-Installations under this permit only include electrical wiring rough-in of the system.An additional • <br /> Fire Alarm Permit is required for review of device location and installation approval. <br /> [II Other(List All): <br /> CODE COMPLIANCE <br /> IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: NO [71 YES—See Below&Pg.2 <br /> 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 <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 /> ARE YOU AN OWNER PERFORMING WORK AS THE CONTRACTOR WITHOUT ELECTRICAL LICENSURE: MN° EYES-See Below&Pg.3 <br /> Pursuant to RCW 19.28.261,property owners and leaseholders cannot perform electrical work on buildings for rent,sale,or lease <br /> without the proper electrical licensing and certification,or exemption.By checking this box, lam stating that I have completed and • <br /> see Page 3 signed the AFFIDAVIT on page 3 of this application to receive an exemption from this licensingicertification requirement. <br /> CONTACT INFORMATION <br /> OWNER NAME: Spencer Livingston TENANT BUSINESS NAME(If Commercial): Amazon DSE4 <br /> OWNER MAIUNG ADDRESS: STREET 6611 Associated Blvd <br /> cm, Everett STATE WA z„, 98203 <br /> OWNER PHONE:80131t)9321 OWNER EMAIL: <br /> CONTRACTOR NAME: EC Electric <br /> CONTRACTOR ADDRESS: s11RE-1,981 Powell Ave SW <br /> cay Renton STATE WA zip 98057 <br /> CONTRACTOR PHONE:206-366-0730 CONTRACTOR EMAIL:Chris.Moeller@ecpowerslife.corn <br /> CONTRACTOR UC.#(REQUIRED):ECCOM-1488A CITY OF EVERETT BUSINESS LIC.#(REQUIRED): <br /> PRIMARY CONTACT: DOWNER { }CONTRACTOR ElOTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:206-356-0730 <br /> Chris Moeller CONTACT EMAIL:Chris.Moelter@ecpowerslile.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 governing this <br /> type of work ad/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 <br /> local law regulating construction or the performance of construction. That I am authorized by the owner of this property to pending the work for which application is made and <br /> comply with the State Contractors Law 18.27 RCW and 288,200141AC. City of Everett Official Use Only <br /> PERMIT#: <br /> / //' <br /> E <br /> Owner/Authorized Agent Signature Date (Revised 1/11/2019) Page 1-Application <br />