2921 PANAVIEW BLVD 2019-09-24 - Laserfiche WebLink

ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES sit ., ,:r 3200 CEDAR STREET, EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE'IINFORMATION PROJECT ADDRESS: 2921 PANAVIEW BLVD BUILDING AREA: 2549 sq ft PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ADDITION ❑TENANT IMPROVMENT ✓❑REMODEL BUILDING USE: ©SFR ❑ TOWNHOUSE ❑ DUPLEX ❑ADU ❑ MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL esELECTRICAL"APPUCATI N INFORMATION &DESCRIPTION Or WORK " CONTRACT PRICE OF WORK:$ 1250 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: ADD CIRCUIT FOR HEAT PUMP INSTALL - UPGRADE PANEL TO 200 AMP PANEL THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ✓❑NO ❑YES-Select Scope: ✓❑ Service ❑ Feeder Cl 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): • _ COD ;COMPLIANCE" - IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: 71 NO CI YES--See Below&Pg. 2 ` f 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: QNO 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: JOHN / SHERRY PRIEST TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET 2921 PANAVIEW BLVD c,T,. EVERETT STATE WA ZIP 98203 OWNER PHONE:425-238-8708 OWNER EMAIL:Priestsd53@gmail.com CONTRACTOR NAME: C.M. HEATING INC CONTRACTOR ADDRESS: STREET 1415 BROADWAY ci- EVERETT STATE WA ZIP 98201 CONTRACTOR PHONE:425-259-0550 CONTRACTOR EMAIL: CONTRACTOR LIC.#(REQUIRED): CMHEAMH877DN CITY OF EVERETT BUSINESS LIC.#REQUIRED): 016098 PRIMARY CONTACT: [DOWNER ©CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:425-259-0550 KAI LANA CONTACT EMAIL:KAILANA@CMHEATING.COM AGREEMENT I hereby certify that t have read and examined this application and know the same to be true and correct, All provtsr`on5 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 r comply with the State Contractors Law 18 27 RCW and 296.200 WAC. City of Everett Official Use Only PERMIT#: .i�7 l / E V30-( i ,rY��/J/,r'�J �!/� r 04/11/19 Owner/Authorized Agent Signature Date (Revised 1/11/2019) Page 1-Application 3