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LLmCTRICAL PERMIT APPLI crit ATION <br /> 476rCITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 (E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: 2313 Cedar Street BUILDING AREA: sq ft <br /> PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ ADDITION ❑ TENANT IMPROVMENT ✓❑ REMODEL <br /> BUILDING USE: SFR ❑TOWNHOUSE ❑ DUPLEX ❑ ADU ❑ MULTI-FAMILY-#OF UNITS: ❑ COMMERCIAL <br /> ELECTRICAL APPLICATION INFORMATION & DESCRIPTION OF WORK <br /> CONTRACT PRICE OF WORK: $ 8500 ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIBE SCOPE OF WORK: <br /> Kitchen remodel <br /> THIS INSTALLATION INCLUDES THE FOLLOWING .SSCOPE: (SELECT ALL THAT APPLY) b <br /> I INF VQI TAGS WORK? ❑ Nt_1 17 YES-Select Scope: ❑ ervice. ❑ Fercu <br /> e der I/1 Ciits-# V ❑ Complete Re-wire <br /> LOW VOLTAGE WORK? ❑ NO ❑ YES-#of Devices: <br /> SELECT SCOPE(REQUIRED): ❑ Data ❑ Intercom ❑Thermostat ❑ Audio El Secure Access ❑ Security System <br /> ❑ 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 /> ❑ Other(List All): <br /> CODE COMPLIANCE <br /> IS THIS PERMIT EDUCATION, INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: ❑ NO ❑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 YOUAN OWNER PERFORMING WORK AS THE CONTRACTOR WITHOUT ELECTRICAL LICENSURE: ENO 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, I am 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 licensing/certification requirement. <br /> CONTACT INFORMATION <br /> OWNER NAME: TENANT BUSINESS NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET <br /> CITY STATE ZIP <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: Garvin Enterprises, Inc <br /> CONTRACTOR ADDRESS: STREET PO BOX 1932 `^, <br /> CITY Marysville STATE WA ZIP 98270 <br /> CONTRACTOR PHONE:360.653.9435 CONTRACTOR EMAIL:Amanda@garvinent.com <br /> CONTRACTOR LIC.#(REQUIRED):GARVIEI991CJ CITY OF EVERETT BUSINESS LIC.#(REQUIRED):039102 <br /> PRIMARY CONTACT: DOWNER ECONTRACTOR ❑OTHER(Please Specify) <br /> CnMTerT NAME• IrnluTArT pH^N:360 653 0435 <br /> Amanda (CONTACT EMAIL:Amanda©garvinent.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 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 <br /> local law regulating construction or the performance of construction. That I am authorized by the owner of this property to perform the work for which application is made and I <br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only <br /> PERMIT#: <br /> arY/-11.4.,2h e—//6//q E <br /> Owner/Authorized Agent Signature Date (Revised 1/11/2019) Page 1-Application <br />