1401 POPLAR ST 2019-09-24 - Laserfiche WebLink

NEN E=CTRICAL PERMIT APPLItTION EVERETT 32CITY OF EVERETT PERMIT SERVICES 00 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 SITEs;INFORMATION. . rY PROJECT ADDRESS: 1401 Poplar St BUILDING AREA: sq ft PROJECT TYPE: ❑NEW CONSTR - =. ❑ADDITION 0 TENANT IMPROVMENT ❑ REMODEL BUILDING USE: ❑SFR "/- • NHOUS ❑ DUPLEX ❑ADU ❑ MULTI-FAMILY-#OF UNITS: ✓❑COMMERCIAL ELEC, RICALAPP 104TION I btFoRmAroNAOESCRIPTION OF WORK CONTRACT PRICE OF WO' : $ 7234.00 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF ORK: Add panel board as a sub panel wit, 100 amp feeder, add 60 amp single phase feeder to main lug load center. Add range plug, dryer$142, an• S amp dedicated circuit from panel board. THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ❑ NO ❑✓ YES-Select Scope: ❑Service 0 Feeder ❑✓ Circuits-#:3 ❑Complete Re-wire LOW VOLTAGE WORK? ✓❑ NO ❑YES-#of Devices: SELECT SCOPE(REQUIRED): El Data ❑ Intercom ❑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. El Other(List All): r CODE'C:OMPiLIANCE IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: ❑ NO ❑YES--See Below&Pg.2 r- 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:1;i1,1(10 DYES-See Below&Pg.3 I Pursuant to RCW 19.28.261,property owners and leaseholders cannot perform electrical work on uildings 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: TENANT BUSINESS NAME(If Commercial): Everett Housing Authority OWNER MAILING ADDRESS: STREET CITY STATE ZIP OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: Garvin Enterprises, Inc. CONTRACTOR ADDRESS: STREET PO BOX 1932 p cny Marysville STATE WA ZIP 98270 CONTRACTOR PHONE: 3606539435 CONTRACTOR EMAIL: Amanda©garvinent.com CONTRACTOR LIC.#(REQUIRED):696-136-01 CITY OF EVERETT BUSINESS LIC.#(REQUIRED):039102 PRIMARY CONTACT: (OWNER ❑✓CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 360.653.9435 CONTACT EMAIL: Amanda@garvinent.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#: E log Owner/Authorized Agent Signature Date (Revised 1/11/2019) Page 1-Application