4701 31ST AVE SE 2019-11-15 - Laserfiche WebLink

a I im mi ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES EVERETT 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 I IE)everetteps@everettwagov I www everettwa govipemilts ' '''';' "'•''''' 'II*M, ',,',kt0-.A' . T ISITEWFORmATION PROJECT ADDRESS: 4701 31St Ave SE BUILDING AREA: sq ft PROJECT TYPE: EZI NEW CONSTRUCTION El ADDITION 0 TENANT IMPROVMENT 0 REMODEL BUILDING USE: WI SFR 7 TOWNHOUSE El DUPLEX 7 ADU El MULTI-FAMILY-#OF UNITS: 7 COMMERCIAL Wiiii:M;44.44oporpico*:J,!,:),::,,, ova istroptiAliou 8,:opticskipytoN OF OR - CONTRACT PRICE OF WORK:$ 250 ASSOCIATED BUILDING PERMIT#Ilf applicable) DESCRIBE SCOPE OF WORK: 100 amp temp power Lot 350 THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE:(SELECT ALL THAT APPLY) LINE VOLTAGE WORK? 21 NO 0 YES-Select Scope El Service El Feeder E Circuits* El Complete Re-wire LOW VOLTAGE WORK? 171 NO El YES-#of Devices: SELECT SCOPE(REQUIRED). 0 Data E1 Intercom 0 Thermostat El Audio 0 Secure Access 0 Security System El 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. E Other(List All)" 4%;,11:Kg..7:,,I6*':-VODE COMPLIANCE' IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND OR PERSONAL CARE FACILITIES: 7 NO ,....j YES—See Bemw&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;ZNO DYES-See Below&Pg. 3 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 licensing/certification requirement, ,1'7777177 ,141011:!;IT-: :.a , . 1: :::0M1,* OWNER NAME: Polygon Homes TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: sfeEsr 11624 SE 5th St Ste 100 Bellevue ...TATP, WA -, 98005 OWNER PHONE' ,OWNER EMAIL: CONTRACTOR NAME: Garner Electric WA LLC CONTRACTOR ADDRESS: sTREET 402 Valley Ave NW Ste 106 crre Puyallup STA1T. WA zip 98371 CONTRACTOR PHONE:2538726051 CONTRACTOR EMAIL:agentele@gweusa.com CONTRACTOR LIC,#cREQUIRED):GARNEEW864KB CITY OF EVERETT BUSINESS LIC.$PREQUIRED): 052909 PRIMARY CONTACT: [ ;OVVNFR VICONTRACTOR F.:OTHER(Please Specify) ------- , CONTACT NAME: CONTACT PHONE:253-278-7864 Paul Vantof CONTACT EMAIL:pvantol@gweusa.com AGREEMENT.1 hereby certify that i have reed and examined this application and know the same to be true and correct. All praVitiOaS 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 pray/spans of any other state or local law regulating construction or the performance of construction. That I am authorized oy the owner of this property to perform the work for whrch application is made and 1 comply with the Stale Contractors Law 18.27 W and 298 200 WAC City of Everett Official Use Only ; — / / ,04 9/24/2019 PERMIT#: OwnertAuthorized Agent Signe re Date (Revised 1/11/2019) Page 1-Application es