725 NILES AVE 2019-11-06 - Laserfiche WebLink

ELECTRICAL PERMIT APPLICATION 4.77* CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 (F)425-257-8810 1 FAX 425-257-8857 1(E)everelteps@everettwa.gov I wvkw.everettwa.govlpermIls PROJECT SITE INFORMATION PROJECT ADDRESS: 725 NILES AVE BUILDING AREA: sq ft PROJECT TYPE: LI NEW CONSTRUCTION ❑ ADDITION ✓❑ TENANT IMPROVMENT ❑ REMODEL BUILDING USE: ❑✓ SFR ❑TOWNHOUSE ❑ DUPLEX El ADU ❑ MULTI-FAMILY-#OF UNITS: ❑ COMMERCIAL ELECTRICAL APPLICATION INFORMATION &DESCRIPTION OF WORK CONTRACT PRICE OF WORK:$ 1,000.00 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: ALTER CIRCUITS TO RE—WIRE GARAGE AND BASEMENT THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY LINE VOLTAGE WORK? ❑ NO Q✓ YES-Select Scope:❑ Service ❑Feeder ❑✓ Circuits-#:4 ❑ Complete Re-wire LOW VOLTAGE WORK? r✓❑ 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.Art additional Fire Alarm Permit is required for review of device location and installation approval. ❑ Other(List All): CODE COMPLIANCE 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, EYES YOU AN OWNER PERFORMING WORK AS THE CONTRACTOR WITHOUT ELECTRICAL LICENSURE: ✓7NO 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: JACOB MORIARTY TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET 725 NILES AVE can EVERETT s;n.rt;WA zir,98201 OWNER PHONE:0425)359-3543 OWNER EMAIL: CONTRACTOR NAME: MERIDIAN CENTER ELECTRIC CONTRACTOR ADDRESS: STREET11109 66TH AVE E CITY PUYALLUP trnrr WA zip 98373 CONTRACTOR PHONE:3604190580 CONTRACTOR EMAIL: MTVPRODUCTION@MCELECTRIC.COM CONTRACTOR LIC.#(REQUIRED): MERIDCE318SG CITY OF EVERETT BUSINESS LIC.#(REOUIREO):44322 ACCOUNT# PRIMARY CONTACT: El OWNER ❑✓CONTRACTOR ['OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:36041 90580 OLIVIA DAVIS CONTACT EMAIL:MTVPRODUCTION@MCELECTRIC.COM AGREEMENT /hereby Certify that I have read and exarnnred this application and knowthesame to be true and correct. Ail provisions of laws and ordinances governing this type of work will be completed whether specified herein or not Ehe 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 vie performance of construclicn. That I am authorised by the:owner of this property to perform the work for which application is made and I comply with the State Contractors tors Law 1827 RCW and 296 200 WAC City of Everett Official Use Only, rPERMIT#: y 1 177,011, •,..nor/Authorized Agent Signature Date (Revised 1111/2019) Page 1-Application