3304 HILL AVE 2019-11-14 - Laserfiche WebLink

ELECTRICAL PERMIT APPLICATION '''� CITY OF EVERETT PERMIT SERVICES '111 ,, . 3200 CEDAR STREET, EVERETT WA98201 Pj 425-257-8810 I FAX 425-257-8857 I(Ey everetteps©everettwa gov www everettwa gov/permits ROJECT SITE INFORMATION 0arkrp PROJECT ADDRESS: 3304 hill Ave PdfCel 00439010100100 BUILDING AREA: 2000 sq ft PROJECT TYPE: L NEW CONSTRUCTION 3 ADDITION El TENANT IMPROVMENT EI REMODEL BUILDING USE: CI SFR >El TOWNHOUSE ®DUPLEX 0 ADU Ell MULTI-FAMILY-#OF UNITS; 7 COMMERCIAL ELE TRICAL.AP UCATION IIIIM O AATION S, DESCRIPTIONrOF'WORK CONTRACT PRICE OF WORK:$ 500.00 ASSOCIATED BUILDING PERMIT#(if applicable): V y l tf Oh-&1 DESCRIBE SCOPE OF WORK: reconnect heater. add low voltage tstat A(Liv THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? El NO 121 YES-Select Scope: l Service El Feeder ❑Circuits-#: D Complete Re-wire LOW VOLTAGE WORK? El NO 121 YES-#of Devices:1 SELECT SCOPE(REQUIRED) CI Data ID Intercom Thermostat El Audio El 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. Q Other(List All): § _ A COD R C lMPLIANCL IS THIS PERMIT EDUCATION,INSTITUTIONAL HEALTH AND/OR PERSONAL CARE FACILITIES: ® NO D YES--See Below&Pg.2 C 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 LIVES-See Below&Pg 3 Pursuant to RCW 19.28 261.property owners and leaseholders cannot perform electrical work on buildings for rent:sate.or lease without the proper electrical licensing and certification,or exemption By checking this box,I am stating that I have completed and gee page 3 signed the AFFIDAVIT on page 3 of this application to receive an exemption from this licensing/certification requirement. CONTACT INFORMATION , OWNER NAME: Hill Street Property TENANT BUSINESS NAME(If Commercial): Fab Tech OWNER MAILING ADDRESS: smeer PO Box 5459 r4 CITY Everett STATE wa zip 982016 OWNER PHONE:(425) 754-5589 OWNER EMAIL:Jennifer@HillStreetlnvestrnentcom CONTRACTOR NAME: Seahurst Electric CONTRACTOR ADDRESS: srneci2915 Chestnut St C,tY Everett sure wa z,„ 98201 CONTRACTOR PHONE:425.258.1852 CONTRACTOR EMAIL:lnovy@seahurst.corn CONTRACTOR LIC.#IREOUIRED1:seahuelQ99QN [CITY OF EVERETT BUSINESS LIC.#tREQUIRED): 18763 PRIMARY CONTACT: EiOWNER ®CONTRACTOR E IOTHER(Please Specify) CONTACT NAME: CONTACT PHONE:425.508,4320 Jon fl OVy CONTACT EMAIL:jnovy@seahurst.com AGREEMENT'I hereby certify that have read and examined this application and know the same to be true and correct All provisions of taws 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 focal law regulating construction or the performance of construction_ That!am authorized by the owner of des property to perforin the work for which application is made and l comp's/with the State Contractors Law 18.27 RCW and 296,200 WAC City of Everett Official Use Only PERMIT it M> r = A 4-25-19 Owner/A . a Ized Agent;'shire Date (Revised 1/11/2019) Page 1-Application