3303 WAVE DR 2019-11-07 - Laserfiche WebLink

ELECTRICAL PERMIT APPLICATION EVERETT CITY OF EVERETT PERMIT SERVICES 3200 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 SITE INFORMATION PROJECT ADDRESS: 3303 Wave Dr BUILDING AREA: 2000 sq ft PROJECT TYPE: ❑ NEW CONSTRUCTION ADDITION El TENANT IMPROVMENT El REMODEL BUILDING USE: ❑✓ SFR ❑ TOWNHOUSE ❑ DUPLEX ❑ADU ❑ MULTI-FAMILY-#OF UNITS: ❑ COMMERCIAL ELECTRICAL APPLICATION INFORMATION & DESCRIPTION OF WORK CONTRACT PRICE OF WORK:$ 2500 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: Panel change THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ❑ NO ❑✓ YES-Select Scope:CI Service ❑ Feeder ❑ Circuits-#: ❑ Complete Re-wire LOW VOLTAGE WORK? ✓❑ NO ❑YES-#of Devices: SELECT SCOPE(REQUIRED):❑ Data ❑ Intercom ❑Thermostat El Audio ❑ Secure Access El 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 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. ARE YOU AN OWNER PERFORMING WORK AS THE CONTRACTOR WITHOUT ELECTRICAL LICENSURE:©NO OYES-See Below& Pg.3 171Pursuant 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: Dennis TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET 3303 Wave Dr CITY Everett STATE WA ZIP 98203 OWNER PHONE:253-347-0899 OWNER EMAIL: CONTRACTOR NAME: William Tibben Cc,c, CONTRACTOR ADDRESS: STREET37804 27th7PI StC J11 Y Federal Way STATE WA ZP 98003 CITCONTRACTOR PHONE:253-347-0899 (CONTRACTOR EMAIL: billy@gohawkelectric.com �— 1 CONTRACTOR LIC.#(REQUIREC):'HAWHE83/LJN CITY OF EVERETT BUSINESS LIC.#(REQUIRE tp_ PRIMARY CONTACT: ❑OWNER ©CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:253-347-0899 Billy Tibben CONTACT EMAIL:billy@gohawkelectric.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 1 comply witf/he State Contractors Law 18.27'CW and 296.200 WAC. City of Everett Official Use Only - PERMIT#: Owner Alic,r Agent nature at� (Revised g g � 1/11/2019) Page 1-Application PP