4966 VESPER DR 2019-11-07 - Laserfiche WebLink

,.ECTRICAL PERMIT APPL1LATION r CITY OF EVERETT PERMIT SERVICES �L�1�w 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps@everettwa.gov I Wxw.everettwa.gov/permits 'PROJECT SITE.INFORMATION .,,.* x <. • PROJECT ADDRESS: 4966 VESPER DR BUILDING AREA: 1200 sq ft PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ADDITION ❑TENANT IMPROVMENT 0 REMODEL BUILDING USE: C✓I SFR El TOWNHOUSE El DUPLEX ❑ADU ❑ MULTI-FAMILY-#OF UNITS: El COMMERCIAL ELECTRICAL APPLICATION INFORMATION & DESCRIPTION OF WORE ,<",w` sf§ N CONTRACT PRICE OF WORK:$ 1928.00 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: ADD 4 CANS IN KITCHEN, 4 CANS IN LIVING ROOM THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ❑ NO �✓]YES-Select Scope:p ❑ Service EI Feeder u Circuits-#:2 ❑ Complete Re-wire _ LOW VOLTAGE WORK? fl NO C YES-#of Devices: r-� SELECT SCOPE(REQUIRED;: El Data ❑ Intercom 17I 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. El Other(List All): CODE'COM,PLIANCE ° e„' IS THIS PERMIT EDUCATION, INSTITUTIONAL, HEALTH AND/OR PERSONAL CARE FACILITIES: 0 NO ❑YES--See Below&Pg.2 By checking this box, I am stating that I have read and understand all of WAC 296-468-900,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: WINO EYES-See Below&Pg.3 r I 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. ��, � n� dF e P ICO TACT`INFORMATIONtgs„:1 y OWNER NAME: MARY POTTER TENANT BUSINESS NAME(If Commercial): �� OWNER MAILING ADDRESS: STREET 4966 VESPER DR CRY EVERETT 5 A- WA 98203 OWNER PHONE:425-210-64r11i OWNER EMAIL: CONTRACTOR NAME: GS HEATING, COOLING & ELECTRICAL LLC CONTRACTOR ADDRESS: s-PEET3409 EVERETT AVE cry EVERETT STATE WA Z'P 98201 CONTRACTOR PHONE:425-610-4257 CONTRACTOR EMAIL:SARA©GSHEATING.COM CONTRACTOR LIC.#(REQUIRED):GSHEAHC8218R CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 60058 PRIMARY CONTACT: ❑OWNERCONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:425-610-4257 SARA HOLLAND CONTACT EMAIL:SARA@GSHEATING.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 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 1 am authorized by the owner of this property to perform the work for which application is made and f comply with the State Contractors Law 18.27 ROW and 296.200 WAC. City of Everett Official Use Only PERMIT#: E L99 z_vcg Owner/Authorized Agent Signature Date (Revised 1/1112019) Page 1-Application