4709 31ST AVE SE 2019-11-15 - Laserfiche WebLink

ma e ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMiT SERVICES EVERETT 3200 CEDAR STREET,EVERETT,WA 98201 WASHINGTON (P)425-257.8810 I FAX 425-257-8857 I(E)everatteps@everettwa.gov I www.everettwa.govtperr is , PROJECT ADDRESS: 4709 31St Ave SE BUILDING AREA: sq ft PROJECT TYPE: Del NEW CONSTRUCTION El ADDITION E..]TENANT IMPROVMENT ❑REMODEL BUILDING USE: 10 SFR El TOWNHOUSE 0 DUPLEX El ADU Li MULTI-FAMILY-#OF UNITS: El COMMERCIAL CONTRACT PRICE OF WORK:$ 250 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: 100 amp temp power Lot 354 THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? CO NO 17 YES-Select Scope El Service ®Feeder El Circuits-#' El Complete Re-wire LOW VOLTAGE WORK? ® NO ❑YES-#of Devices: El SELECT SCOPE(REQUIRED): El Date El Intercom E Thermostat Audio El 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. El Other(List All)' z.. ... 5 .V. . :,.,, _ .. I ,t$. l4- F ..,. ", : _ MPUANCE.% , , l ��.,''' :. '". . '„, IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: © NO YES--See Below&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 EYES YOU AN OWNER PERFORMING WORK AS THE CONTRACTOR WITHOUT ELECTRICAL LICENSURE: ZNO EYES-See Below&Pg. 3 Pursuant to RCW 19.28.261,property owners and leasahoiders 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 licensingtcertification requirement. OWNER NAME: Polygon Homes TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: erir_r 11624 SE 5th St Ste 100 c,r, Bellevue f7 .K: WA yip 98005 OWNER PHONE: OWNER EMAIL: ,s mr --2,, ., ,6 .2 .,,,. a CONTRACTOR NAME: Garner Electric WA LLC CONTRACTOR ADDRESS: STREET 402 Valley Ave NW Ste 106 e,r Puyallup s:TA,E. WA x, 98371 CONTRACTOR PHONE:253-872-6051 CONTRACTOR EMAIL:agentele@gweusa.com CONTRACTOR LIC.*(REQUIRED):GARNEEW864KB ICITY OF EVERETT BUSINESS LIC.*(REQUIRED): 052909 PRIMARY CONTACT: IIOWNER R1CONTRACTOR FlOTHER(Please Specify) CONTACT NAME: CONTACT PHONE:253-278-7064 Paul Vantot CONTACT EMAIL:pvarttal'")p gweusa.com AGREEMENT t 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 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 stale or local law regulating construction or the performance of construction, That lam authorized by the owner of this property to perform the work for which application is made and 1 comply withthe State Contractors Law f8�. RCW and 295.X00 WAC, City of Everett Official Use Only f r 'PERMIT#: -17?: ,_,, 4,'''i .r# I {` 9/24/2019 b t 1 D 0weerlAuthorized Agent 9igntlrure Date (Revue 1/11/201-9) Page 1-Application