315 E BEECH ST 2019-10-31 - Laserfiche WebLink

ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES EVERETT 3200 CEDAR STREET,EVERETT,WA 98201 WASHINGTON (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov www.everettwa.gov/permits ,�. -;' tea. �:• .-.. ,.�.. ,. _ ,... <y _ .;�, .. .:,• .. • a_ •eax_= PROJECT ADDRESS: 315 5 D eec.� "/ BUILDING AREA: CO9 "-- /, 2 sq ft PROJECT TYPE: El NEW CONSTRUCTION ❑ADDITION ❑TENANT IMPROVMENT VI REMODEL BUILDING USE: ®SFR El TOWNHOUSE El DUPLEX El ADU El MULTI-FAMILY-#OF UNITS: ❑ COMMERCIAL CONTRACT PRICE OF WORK:$ l 2 ,or ASSOCIATED BUILDING PERMIT#(if applicable): / DESCRIBE SCOPE OF WORK: 1242 to t`I/`e n � -1 /t'cz i R ®-e hS2 ' etCZ 1 1- h 1/ 2000 12-c ( THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? RI NO El YES-Select Scope:❑ Service El Feeder ❑Circuits-#: ❑Complete Re-wire LOW VOLTAGE WORK? ►2 NO ❑YES-#of Devices: SELECT SCOPE(REQUIRED): El Data El Intercom ❑Thermostat ❑Audio ❑Secure Access Cl 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): IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: • NO • 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 YOUAN OWNER PERFORMING WORK AS THE CONTRACTOR WITHOUT ELECTRICAL LICENSURE: ONO OYES-See Below&Pg.3 f 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 5��S�ee Page 3 signed the AFFIDAVIT ons page 3y�o�f this application too receive Xan,exemption from this licensing/certification requirement. "-V _ 1 ,tl,'�y At�Q1C... s_hS s p\`1 � '62�jr� li^^, ,.moi t^v`�' as.`a!�SRR`:si'a4t,i, i.,,, Ez a\ t� � .``AR AN�V��\R'. OWNER NAME: TENANT BUSINESS NAME(If Commercial) OWNER MAILING ADDRESS: STREET 15 6 gizec ti CITY STATE ZIP OWNER PHONE: !OWNER EMAIL:_ _m ow • N• �,� �.d CONTRACTOR NAME: E.yveircl( o .c) �GC iu�� / y�/C CONTRACTOR ADDRESS: S REET ( 27-22 )'l`'�t1 `T1/// (Jr/J // CrrY ( ' 'icer 1f[1(�. STATE(/✓i'� ZIPVI 7/ CONTRACTOR PHONE: 112. 737422 CONTRACTOR EMAIL: CONTRACTOR LIC.#(REQUIRED):ENCRC7F 339q Z Icily OF EVERETT BUSINESS LIC.#(REQUIRED)57 p PRIMARY CONTACT: El OWNER 2 CONTRACTOR ❑OTHER(Please Specify) 7 CONTACT NAME: CONTACT PHONE: -(2S - 7 3 - 2_7 VY11 jrUONTACT EMAIL: AGREEMENT::1 heby certi 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 comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only PERMIT#: l-1 E 1/ 01 ft er/:• ori Agent Signature Date (Revised 1/11/2019) Page 1-Application