500 47TH ST SE 2019-11-15 - Laserfiche WebLink

ELECTRICAL PERMIT APPLICATION EVERETTCITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 WASHINGTON (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.govlpermits PROJECT SITE'INFORMATION PROJECT ADDRESS: 500 47th ST SW Everett 98203 BUILDING AREA: sq ft PROJECT TYPE: ❑NEW CONSTRUCTION ❑ADDiTION ❑TENANT IMPROVMENT O REMODEL BUILDING USE: El SFR ❑TOWNHOUSE ❑DUPLEX ❑ADU ❑MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL ELECTRICAL.APPLICATION INFORMATION &DESCRIPTION,OF WORK,.: ,_. ,,, CONTRACT PRICE OF WORK:$ 1850 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: 200 amp panel change THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE:(SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ❑NO ❑✓ YES-Select Scope:❑✓ Service ❑Feeder ❑Circuits-#: ❑Complete Re-wire LOW VOLTAGE WORK? ❑✓ NO El YES-#of Devices: SELECT SCOPE(REQUIRED): ❑Data ❑Intercom ❑Thermostat El Audio ❑Secure Access ❑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, ❑Other(List All): CODE COMPLIANCE .. .. ' IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: ❑NO ErYES—See Below&Pg.2 fl 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:EINO DYES-See Below&Pg.3 C 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. OWNER NAME:Zack Wait TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET 500 47th ST SE p Cny Everett STATE wa ZIP 98203 OWNER PHONE:na OWNER EMAIL:na CONTRACTOR NAME: In House Electrical Services, Inc. CONTRACTOR ADDRESS: STREET 1530 117th DR SE Com, Lake Stevens STATE WA zip 98258 CONTRACTOR PHONE:4257603203 CONTRACTOR EMAIL:kelsey@inhouseelectric.com CONTRACTOR LIC.#(REQUIRED):inhaues952gg CITY OF EVERETT BUSINESS LIC.#(REQUIRED):044168 PRIMARY CONTACT: ❑OWNER ✓❑CONTRACTOR ['OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:4253209149 Kelsey CONTACT EMAIL:kelsey@inhoUSeelectriC.Com AGREEMENT:1 hereby certify that I have read and examined this application and know the same to be tore 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 performs • struction. That I am authorized by the owner of this property to perform the work for which application Is made and t comply State Co .ctors Law 1: ' ' 96.200 WAC. City of Everett Official Usa Only PERMIT#: 02 AVIA% 47/47,- E Ow rfAuthor"rd Agent S'nature `` ':to (Revised 1/11/2019) Page 1-Application Scanned with CamScanner