2601 23RD ST 2019-11-15 - Laserfiche WebLink

ItECTRICAL PERMIT APPLILPJION CITY OF EVERETT PERMIT SERVICES EVERETT 3200 CEDAR STREET,EVERETT,WA 98201 (P1 425-257-8810 I FAX 425-257-8857 I AE)everettees@everettwa.goi I wvvw.evefettwa.govipermits WASHINGTON -17-wtr!wz', PROJECT ADDRESS: 2601 23rd St Everett WA 98201 BUILDING AREA: sqft PROJECT TYPE: Pi NEW CONS • CTION X DDITION LI TENANT IMPROVMENT Li REMODEL BUILDING USE: El SFR TsnrrVNHOUSE DUPLEX El ADL) 173 MULTI-FAMILY #OF UNITS: 7 COMMERCIAL ELE CAL APPLICATION INFORMATION Se DESCRIPTION OF WORN CONTRACT PRICE OF WOR I ASSOCIATED BUILDING PERMIT*(if applicable): DESCRIBE SCOPE OF W•RK: Run sl 0 arno circuit out to shed in backyard THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? LI NO EI YES -Select Scope: LI Service LI Feeder EJ Circuits-#: P Complete Re-wire LOW VOLTAGE WORK? NO 0 YES- f of Devices: SELECT SCOPE REQUIRED): El Data LI Intercom 0 Thermostat .0 Audio El Secure Access El Security System U Fire Alarm-Installations under this permit only include electrical wiring rough-in of the system.An additional Fire Alarm Permit t required for review of device location and Instalation approval. El Other(List All): coDEacIS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: ci NO LI YES–See Below&Pg.2 11 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: ONO OYES-See Below&Pg. 3 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 licensinlcertification requirement. CONTACT INFORMATION— OWNER NAME: Daniel Lawson TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: sTRErr 2601 23rd St Cm, Everett sTA, WA z,„ 98201 OWNER PHONE: 9102646963 OWNER EMAIL: CONTRACTOR NAME: Aqua line Plumbing, Electrical and Heating LLC CONTRACTOR ADDRESS: sTREET 625 Strander Blvd litA CnY Tukwila STAT F: WA zip 98188 CONTRACTOR PHONE: 2068768498 'CONTRACTOR EMAIL:Aqualinefamily©gmail.corn CONTRACTOR LIC CR EouIRED):AOUALPE81389 CITY OF EVERETT BUSINESS LIC.rrf REQUIRED 09912 PRIMARY CONTACT: [ ]OWNER I:CONTRACTOR E]OTHER(Please Specify)_ --- CONTACT NAME: Daniel Lawson CONTACT PHONE:9102648983 CONTACT EMAIL: AGREEMENT.I hereby certify that I have read and examined MIS Joification and know the same lobe true and correct AO'provisions of laws and ordinances governing tins type of work will be completed whether specified herein or not. The granting of a permit does not presume 10 owe a uthonty to violate or cancel the provisions of any other slate or local Jaw regutating consttuction or the performance of constmcfion. That I am authorized by the owner of this property to perform the work for which application is made and( °amplywith the State Contractors Law f 8.27 RCW and 296200 WAC. City of Everett Official Use Only PERMIT#: 10/15/2019 E co OwnerlAuthorize7d Agent Slgure Date 'fr/evised 1. i2O15.. Page 1-App I ic.at ion