6300 MERRILL CREEK PKY WATERTECTONICS 2019-07-08

s, t��l I ELECT (TROCH � L PERMIT ".PPL�C A now CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 ,:,C# (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps@everettwa.gov 1 www.everettwa.gov/permits _____. PROJEdY SETE INIFORLWATIJOI1 .- - 2 ----------------- ----- 1 _ _____________ _ 1PROJECT ADDRESS: cGj 3®e V e✓411.I / 1 i Crtlee_L -prL,J)(13UILDING AREA: sq ft (PROJECT TYPE: 0 NEW CONSTRUCTION 0 ADDITION C: TENANT IMPROVMENT 0 REMODEL COMMERCIAL l BUILDING USE: 0 SFR 0 TOWNHOUSE 0 DUPLEX 0 ADU D MULTI-FAMILY-#OF UNITS: — r ----ELECTRICAL CAL PP CQTR INFORM 4,Ti IOC' & DESCRWP'TIOR OF WORK CONTRACT PRICE OF WORK:$ ,) ©ad 0 cd ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: W 3 vv, \ ( - v� —.e - 0 1f s �eL� ( lll,c�. I �S F 6� s THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) �� YES-Select Scope:p 0 Service 0 Feeder Circuits-#: 0 Complete Re-wire LINE VOLTAGE WORK? 0 NO � LOW VOLTAGE WORK? 0 NO 0 YES-#of Devices: SELECT SCOPE(REQUIRED): 0 Data 0 Intercom ©Thermostat 0 Audio 0 Secure Access D Security System 0 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. IS THIS PERMIT EDUCATION, INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: C NO • YES—See Below&Pg.2 0 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: ego DYES-See Below&Pg. 3 rrim�st Pursuant to RCW 19.28.261,property owners and leaseholders cannot perform electrical work on buildings for rent,sale,or lease 1 3 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 Commercial): .�r�12� GC f d/l�_ . .. _ OWNER NAME: I r i 1 CTO N ICS TENANT BUSINESS / (If( ) I c 5 OWNER MAILING ADDRESS: STREET (-,30 0 Y�t rt.ri.l II C rt.e ' L r__,4 ,/' l �� Ev .�/H STATE �'�/A- . ZIP CITY � ,-• -�Q OWNER EMAIL. p'[(%v'[fXP . TO KA, SO co a tYK} &.A)(c-5 ' co i ( OWNER PHONE: .............. ..J ,�- /t CONTRACTOR NAME: I ctClt-' I -L l� s lie Gf/ttc CONTRACTOR ADDRESS: STREET 75-6-1 A) c f)_() 7 N__ri pi CITY CG L/ `//v t 6 ctSTATE `� 'e ( ti{"r ZIP (g D C/ CONTRACTOR PHONE: CONTRACTOR EMAIL: 1J e V 1' t S s , '2 L'e i3 6 J I'�eif t,cc) CONTRACTOR LIC.#(REQUIRED) FA C I L-EG fel I N Q 'CITY OF EVERETT BUSINESS LIC.#(REQUIRED _ ): Sw PRIMARY CONTACT: I:OWNER 'e CONTRACTOR ❑OTHER(Please Specify) �/ CO CT NAME: , CONTACT PHONE: L12 s---- S— 3 5-4/cc - De V t v ( SNo4 , CONTACT EMAIL: ') .,eH t , P eel2C'c.. 3 ay sol f I `ce 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 o 'minces governing this type of work will be completed whether specified herein or not. The granting of a permit does not presume to give authorityto violate or cancel the 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 work for Evereth t Oplicaic ati ion Use Onlis and I City comply wit e Contractors Law 18.27 RCW and 296.200 WAC. ett-- U .. PERMIT#: E \ 0.' 0),,- cl D C2—...--/\'"-- Owner/Authorized Agent Signature Date (Revised 1/11/2019) Page 1-Application