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3405 BELL AVE 2019-09-04
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3405 BELL AVE 2019-09-04
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9/4/2019 11:13:58 AM
Creation date
9/4/2019 11:13:48 AM
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Address Document
Street Name
BELL AVE
Street Number
3405
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ELECTRICAL F LiZMIT & FIRE ALARM PE_JIIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 I (E) everetteps@everettwa.gov I www.everettwa.gov/permits <br /> 4ETT <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS:3405 Bell Ave <br /> PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ADDITION ' ,TENANT IMPROVMENT ❑REMODEL <br /> BUILDING USE: ✓❑SFR ❑TOWNHOUSE ❑ DUPLEX ❑ADU ❑ MULTI-FAMILY-#OF UNITS: ❑ COMMERCIAL <br /> BUILDING AREA: sq ft <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK: $800.00 ASSOCIATED BUILDING PERMIT#(if applicable): <br /> IS THIS LOW VOLTAGE WORK? ✓❑ NO ❑ YES-#OF DEVICES: <br /> IS THIS A FIRE ALARM PERMIT? ✓❑ NO ❑ YES-Plans required for review(Both Electrical and Fire Department inspections are required) <br /> DESCRIPTION OF WORK & CODE COMPLIANCE <br /> DESCRIPTION OF WORK: Testing and verifying circuits <br /> IS THIS PERMIT EDUCATION, INSITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: 7 NO ❑YES--See Below&Pg.2 <br /> I <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: ✓❑NO DYES-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 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: Mountain West Properties LLC TENANT BUSINESS NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 1027 N 48th St <br /> cm, Seattle STATE WA ZIP 98103 <br /> OWNER PHONE:360-789-7182 OWNER EMAIL:mountainwestpropertiesllc@gmail.com <br /> CONTRACTOR NAME:Valley Electric <br /> CONTRACTOR ADDRESS: STREET 1100 Merrill Creek Parkway <br /> CITY Everett STATE WA ZAP 98203 <br /> CONTRACTOR PHONE:425-407-0832 CONTRACTOR EMAIL:permits@velectric.com <br /> CONTRACTOR LIC.#(REQUIRED):VALLEEC141 NA CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 022558 <br /> PRIMARY CONTACT: ❑OWNER ✓❑CONTRACTOR CI OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:425-367-2980 <br /> Jayson Antti l le CONTACT EMAIL:jaysona@velectric.com <br /> AGREEMENT/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 /> � <br /> 1/18/19 et ) ( `iJ <br /> D(1 ®Dm <br /> Owner/Authorized Agent Signature Date (Revised 11/5/2018) Page 1-Application <br />
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