2031 MCDOUGALL AVE 2019-11-06 - Laserfiche WebLink

ELECTRICAL PERMIT & FIRE ALARM PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 (P)425-257-8810 1 FAX 425-257-8857 I (E)everetteps@everettwa.gov l www.everettwa.gov/permits PROJECT EITEINFORMATION PROJECT ADDRESS:2031 MCDOUGALL AVE PROJECT TYPE: 0 NEW CONSTRUCTION 0 ADDITION El TENANT IMPROVMENT ❑✓ REMODEL BUILDING USE: Q SFR ❑TOWNHOUSE El DUPLEX El ADU ❑ MULTI-FAMILY-#OF UNITS: El COMMERCIAL BUILDING AREA: 945 sq ft :ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK:$250 ASSOCIATED BUILDING PERMIT#(if applicable): IS THIS LOW VOLTAGE WORK? © NO ❑YES-_#OF DEVICES: is THIS A FIRE ALARM PERMIT? 171 NO ❑ YES-Plans required for review(Both Electrical and Fire Department inspections are required) DESCRIPTION OF.WORK''&.CODE COMPLIANCE DESCRIPTION OF WORK: APP CIRCUIT FOR,SING..E. QNE DUCTLESS INSTALL IS THIS PERMIT EDUCATION,INSITUTIONAL,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 YOU AN OWNER PERFORMING WORK AS THE CONTRACTOR WITHOUT ELECTRICAL LICENSURE:KINO DYES'-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 signed the See Page 3 AFFIDAVIT on page 3 of this application to receive an exemption from this licensing/certification requirement. CONTACT INFORMATION OWNER NAME:ALYSSA HEATON TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET2031 MCDOUGALL AVE CITY EVERETT STATE WA zip 98201 OWNER PHONE:425-259-0550 OWNER EMAIL:KAILANA@CMHEATING.COM CONTRACTOR NAME:C.M. HEATING INC 'CONTRACTOR ADDRESS: STREET 1415 BROADWAY _... __. .__.. STATE WA ZIP ciw EVERETT 98201 CONTRACTOR PHONE:425-259-0550 'CONTRACTOR EMAIL:KAI LANA@CMHEATING.COM CONTRACTOR LIC.#REQUIRED:CMHEAMH877DN 016098, ( ) CITY OF EVERETT BUSINESS LIC.#(REQUIRED): PRIMARY CONTACT: ❑OWNER ©CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:425-259-0550 KA I LANA CONTACT EMAIL:KAILANA@CMHEATING.COM AGREEMENT:1 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 goveMing this type ofd will be completed whether,speCified herein or not The granting of a;permit does not pasterns to give authority to violate or cancel the previsions of any other,state or local law regulating construction or the performance of construction: That I am autholzed by the owner of this property to perform the i leo.*Ax whleh applleetten le made and 1 comply with the:Stele Cenfreetem taw 18 27 RCW and 298 200 WAG., City of Everett Official Use Only PERMIT* di-4414' � ,, � 03!08/19 C ‘,. CA C6 .... Cci Owner/Authorized Agent Signature Date (Revised 11/5/2018) Page 1-Application „ I