1910 49TH ST SW 2019-09-10 - Laserfiche WebLink

ELe.CTRICAL PERMIT APPLIVPMON CITY OF EVERETT PERMIT SERVICES 014 .1.°7—"4 ,400 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 FAX 425-.257-8857 (E)everatteas@everettwa.gov www.everettwa:gov/permiN PROJECT SITE INFORMA PMM PROJECT ADDRESS: 191() 49th St SW BUILDING AREA: so ft PROJECT TYPE: H NEW CONSTRUCTION 0 ADDITION 0 TENANT IMPROVMENT 1,;,/1 REMODEL r- BUILDING USE: L_i SFR 7 TOWNHOUSE U DUPLEX D ADU U MULTI-FAMILY-/1 OF UNITS: 7 COMMERCIAL ELECTRICAL APPLICATION INFORMATION 81 DESCRIPT ON OF WORK CONTRACT PRICE OF WORK: $ 600 ASSOCIATED BUILDING PERMIT ifif applicable): DESCRIBE SCOPE OF WORK: add two 120v receptacles in basement THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) UNE VOLTAGE WORK? 0 NO YES-Select Scope: 0 Service 0 Feeder 0 Circuits-4k? U Complete Re-wire LOW VOLTAGE WORK? 0 NO D YES-#of Devices: SELECT SCOPE(REQUIRED): 0 Data 0 Intercom 0 Thermostat 0 Audio El Secure Access 0 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. El Other(List Alt). CODE COMPLIANCE IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: al NO al YES--See Below&Pg.2 By checking this box,1 am stating that I have read and understand all of WAG 296-468-900,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: ( NO OYES-See Below&Pg.3 — Pursuant to ROW 19,28.261,property owners and leaseholders cannot perform electrical work on buildings for rent,sale,or lease 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 OWNER NAME: Sarah Wilkerson TENANT BUSINESS NAME If Commercial): OWNER MAILING ADDRESS: srer41. 1910 - 49th St SW ctry everett sTAIL wa 98203 OWNER PHONE:2069924403 OWNER EMAIL: CONTRACTOR NAME: Emerald Electric NW CONTRACTOR ADDRESS: siriLLI 9830 220th pl se CQ02. cnv snehomish wa 98296 CONTRACTOR pHoNE:4254461003 CONTRACTOR eiviAIL:ictey@erneraldelectrichw,com CONTRACTOR LIC.fl(REOUIRLD):emer8en902dt CITY OF EVERETT BUSINESS LIC. PRIMARY CONTACT: DOWNER EICONTRACTOR DOTHER(Please Specify) CONTACT NAME: CONTACT PHONE:4254461 003 Joey CONTACT EMAIL: 4 AGREEMEN r.I'name,Pettily that I have mad end examined this application and know the same to be true and borrea AN provrsions of laws and ordinances governing this type of work mil be completed whether specified heroin or not. The granting of a pennit does not presume to give authonty to vioiete or cancel the provisions of any other state or local law ingtifetrag construction or the performance of construction. That!em ournonzoir by the owner of this property to perform the work for which application is made and! comply with the State Contractors Law18 27 PCW end 295 200 WAC City of Everett°MOW use Only PERtvilT / E Owner uthorized Agent Signature Date (Revised 1/111201e) Page'I-Application