2102 HIGHLAND AVE B 2019-11-14 - Laserfiche WebLink

ILECTRICAL PERMIT APPATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 { FAX 425-257-8857 1(E)everettepstgeverettwa.gov I w ww.everettwa.govfpermits f PROTECT,SITE INFORMATION :: z PROJECT ADDRESS: 2102 HIGHLAND AVE APT B BUILDING AREA: 960 sq ft PROJECT TYPE: El NEW CONSTRUCTION El ADDITION 0 TENANT IMPROVMENT O REMODEL BUILDING USE: ❑SFR O TOWNHOUSE El DUPLEX 0 ADU El MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL Stlgi:MakalgiglItgc;FRIA4.14lAReppATIONANEPRIVIATIONt44.11ESPRIPTIONtiPraWPWRINWRAMONM CONTRACT PRICE OF WORK:$ 2344.24 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: NEW CIRCUIT FOR TRASH COMPACTOR, HANG 2 CEILING FANS, REPLACE BATH FAN AND LAUNDRY FAN THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? El NO [✓ YES-Select Scope:❑Service El Feeder ❑✓ Cirouits-#:2 El Complete Re-wire LOW VOLTAGE WORK? O NO 0 YES-#of Devices: SELECT SCOPE(REQUIRED): ❑ Data 0 Intercom ❑Thermostat 0 Audio El Secure Access 0 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. 0 Other(List All): lZiS-WMIM:ganIARaiakigqgggg::SRMSRPSPP,kPP.,M.PJ41.4NPE-K:ggiNgZag::,:tgEnMZIKMBsgnaiRNRRRERE IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: O NO El YES—See Below&Pg.2 By checking this box,I am stating that I have read and understand all of WAC 296.46B-3110,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: ONO OYES-See Below&Pg.3 Pursuant to ROW 19.28.261,property owners and leaseholders cannot perform electrical work on buildings for rent,sale,or lease V 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. 5 . r:i:;, z'..,,2' , ,.. .. `r :N .:::;,, l; ° ,,CONTACT INFORMATION° 3 : ..,.£,,;z:, , OWNER NAME: JULIE SPRINGER TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET 2102 HIGHLAND AVE APT B c€Tv EVERETT STATE WA 7.fp 98201 OWNER PHONE:509-260-0699 OWNER EMAIL:JULIESPRIN@GMAIL.COM CONTRACTOR NAME: GS HEATING, COOLING&ELECTRICAL LLC CONTRACTOR ADDRESS: STREEr3409 EVERETT AVE crTr EVERETT STATE WA Zrp 98201 CONTRACTOR PHONE:425-610-4257 CONTRACTOR EMAIL SARA@GSH ATING,COM CONTRACTOR LIC.#(REQUIRED):GSHEAHC8218R CITY OF EVERETT BUSINESS LIC.#REQUIRED):60058 PRIMARY CONTACT: DOWNER OCONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:425..610-4257 SARA HOLLAND CONTACT EMAIL:SARA@GSHEATING.COM AGREEMENT:I hereby certify that 1 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 l am authorized by the owner of this property to perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only PERMIT# �� 9- t��rt `� E Owner Au arize1i nl:"Signatu Date (Revised 1!14/2019) Page 1-Application