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ELECTRICAL PERMIT APPLICATION <br /> 'EVERETT 32CITY OF EVERETT PERMIT SERVICES <br /> 00 CEDAR STREET, EVERETT,WA 98201 <br /> WASHINGTON 7 ` <br /> (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> PROJECT ADDRESS: 7131 Yew st BUILDING AREA: sq ft <br /> PROJECT TYPE: ❑NEW CONSTRUCTION El ADDITION ❑TENANT IMPROVMENT El REMODEL <br /> BUILDING USE: ❑SFR El TOWNHOUSE El DUPLEX ❑ADU El MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL <br /> CONTRACT PRICE OF WORK:$ 350 ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIBE SCOPE OF WORK: FRUNACE CHANGE OUT ADD AC <br /> THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) <br /> LINE VOLTAGE WORK? El NO ❑YES-Select Scope: ❑ Service ❑ Feeder ❑Circuits-#: El Complete Re-wire <br /> LOW VOLTAGE WORK? ❑NO El YES-#of Devices: <br /> SELECT SCOPE(REQUIRED): ❑Data ❑ Intercom ®Thermostat ❑Audio El Secure Access ❑Security System <br /> ❑Fire Alarm-Installations under this permit only include electrical wiring rough-in of the system.An additional <br /> Fire Alarm Permit is required for review of device location and installation approval. <br /> ❑Other(List All): <br /> S .v - p_�i "F, _1 f <br /> .>;" �'�,a� _.�..?� Y�.4 d r,. <br /> IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: ® NO El YES--See Below&Pg.2 <br /> I I 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 <br /> of this application(see next page),AND Plan Review is NOT required because I meet all of the following sub sections that do not <br /> See Page 2 require Plan Review. <br /> ARE YOUAN OWNER PERFORMING WORK AS THE CONTRACTOR WITHOUT ELECTRICAL LICENSURE: ©NO EYES-See Below&Pg.3 <br /> nI I Pursuant to RCW 19.28.261,property owners and leaseholders cannot perform electrical work on buildings for rent,sale,or lease <br /> without the proper electrical licensing and certification,or exemption.By checking this box, I am stating that I have completed and <br /> See Page 3 signed the AFFIDAVIT on page 3 of this application to receive an exemption from this licensing/certification requirement. <br /> .+,.#.: ,�.M -ros` 70 agf`ilapr ,2-,=`"+3i @AT-� r .�N o:�`r`m�, .�,< ✓.,�` , Nr„r, �sr ,^._ . �'s„" *�'#r;` to i . , `^, <br /> OWNER NAME: Eugene Walker TENANT BUSINESS NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 7131 Yew st <br /> CITY EVERETT STATE wa ZIP 98203 <br /> OWNER PHONE: 425 210 1620 OWNER EMAIL: bmw833@yahoo.com <br /> ...,. ..e ,tnaA... :-. *. .„... .,".„ „ .r.Fw,.,?a r.. + :a „ <br /> CONTRACTOR NAME: MM COMFORT SYSTEMS <br /> CONTRACTOR ADDRESS: STREET 18103 NE 68TH ST SE, C-200 <br /> CITY REDMOND STATE WA ZIP 98052 <br /> CONTRACTOR PHONE: 425-881-7920 CONTRACTOR EMAIL: PERMITS@MMCOMFORTSYSTEMS.COM <br /> CONTRACTOR LIC.#(REQUIRED): M EVERETT CITY OF BUSINESS LIC.#(REQUIRED): 055245 <br /> COMCS8 9PT <br /> PRIMARY CONTACT: DOWNER ❑CONTRACTOR ['OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 4255-629_10255. <br /> Jenah Barlow CONTACT EMAIL: PERMITS@MMCOMFORTSYSTEMS.COM <br /> 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 <br /> 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 <br /> 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 I <br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only <br /> PERMIT#: <br /> E q,O°1 J 01 (P <br /> Owner/A th rize ge Signatu Date (Revised 1/11/2019) Page 1-Application <br />