1213 HOYT AVE 2019-09-23 - Laserfiche WebLink

112 tLECTRICAL PERMIT APPLICATION EVERETT CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 WASHINGTON (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 1213 Hoyt Ave BUILDING AREA: N/A sq ft PROJECT TYPE: LI NEW CONSTRUCTION ❑ADDITION ❑TENANT IMPROVMENT ❑ REMODEL BUILDING USE: ❑✓ SFR El TOWNHOUSE ❑ DUPLEX ❑ADU ❑ MULTI-FAMILY-#OF UNITS: ❑ COMMERCIAL ;:ELECTRICAL APPLICATION NFORMATI N &DESCRIIPTIION OF WORK CONTRACT PRICE OF WORK:$ 550.00 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: Add exterior weatherproof outlet to rear deck. THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ✓❑ NO ❑ YES-Select Scope: ❑ Service El Feeder El Circuits-#: El Complete Re-wire LOW VOLTAGE WORK? ✓❑ NO El YES-#of Devices: SELECT SCOPE(REQUIRED): Cl Data ❑ Intercom El Thermostat El Audio El 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. E l Other(List All): CODE.COMPLIANCE' IS THIS PERMIT EDUCATION, INSTITUTIONAL, HEALTH AND/OR PERSONAL CARE FACILITIES: NO El 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: Paul Wells-Edwards TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET 1213 Hoyt Ave CITY Everett STATE WA ziP 98201 OWNER PHONE:(360) 2824890 OWNER EMAIL:paUlw@graphiCOde.COm CONTRACTOR NAME: Full Spectrum Design CONTRACTOR ADDRESS: sTREET4859 Alpine Drive c,Ty Everett STATE WA ZIP 98203 CONTRACTOR PHONE:425-330-5469 CONTRACTOR EMAIL:fullspectrUmdesign@hotmail.com CONTRACTOR LIC.#(REQUIRED):FULLSD*044KG CITY OF EVERETT BUSINESS LIC.#(REQUIRED):#028519 PRIMARY CONTACT: ['OWNER LICONTRACTOR ['OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:(360) 282-4890 Paul Wells-Ed)CONTACT EMAIL:paulw@graphicode.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#: 1 �16/26/2019 EI J 1 Owner/Authorized Agent Signature Date (Revised 1/11/2019) Page 1-Application