10407 HOLLY DR 2019-09-23 - Laserfiche WebLink

ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 FAX 425-257-8857 (E)everetteps@everettwa.gov I www.everettwa.gov/permits .,:PR EC S ` NF .aT Oil PROJECT ADDRESS: 1 0407 Holly Dr BUILDING AREA: sq ft PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ADDITION ❑TENANT IMPROVMENT ❑ REMODEL BUILDING USE: E SFR ❑TOWNHOUSE El DUPLEX ❑ADU ❑MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL ELECTRICAL APPLICATION INFORMATION,& DESCRIPTION OF WORK CONTRACT PRICE OF WORK:$600 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: 1-20a circuit for sump pump outlet THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ❑ NO ®YES-Select Scope: ❑Service ❑ Feeder ©Circuits-#: 1 ❑Complete Re-wire LOW VOLTAGE WORK? NO ❑YES-#of Devices: SELECT SCOPE(REQUIRED): ❑ Data ❑ Intercom ❑Thermostat ❑Audio ❑Secure Access ❑Security System ❑ 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): Cope coMP ANCE,, IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: ✓❑ NO Li YES--See Below&Pg.2 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: ENO EYES-See Below&Pg.3 Pursuant to RCW 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:GuStavo Plancarte TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET1 0407 Holly Dr Cry Everett STATE WA Z,P98204 OWNER PHONE: 425-268-8585 OWNER EMAIL: gustavop@ outlook.Com CONTRA.,.... CTOR NAME: Switch Electric CONTRACTOR ADDRESS: STREET 7226 139th Ave NE CITY Lake Stevens STATE WA ZIP 98258 CONTRACTOR PHONE:425-244-5511 1CONTRACTOR EMAIL:service@myswitchelectric.com CONTRACTOR LIC. SWI kICITY OF EVERETT BUSINESS LIC.#(REQUIRED) 05255/ PRIMARY CONTACT: DOWNER ✓❑CONTRACTOR ['OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:253-376-7662 Tiffany Erickson CONTACT EMAIL:tiffany@ myswitchelectric.com 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 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 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 comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only PERMIT#: q 3/26/19 E ` 1 O 9- 3 Owner/Authorized Agent Signature Date (Revised 1/11/2019) Page 1-Application