2702 59TH ST SW 2019-11-15 - Laserfiche WebLink

ELECTRICAL PERMIT APPLIjr=►TION 4rErrCITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits � KOJECT SIITE INFORMATION PROJECT ADDRESS: 2702 59th St SW BUILDING AREA: _ sq ft PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ADDITION 0 TENANT IMPROVMENT El REMODEL BUILDING USE: ❑✓ SFR ❑TOWNHOUSE ❑ DUPLEX ❑ADU ❑ MULTI-FAMILY-#OF UNITS: ❑ COMMERCIAL ELECTRICAL APPLICATION IINFORMATION �&.DESCRIPTION OF WORK CONTRACT PRICE OF WORK: $ 350 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: Replacing like for like gas furnace THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ❑ NO ❑✓ YES-Select Scope: ❑ Service ❑ Feeder ❑ Circuits-#:1 ❑ Complete Re-wire LOW VOLTAGE WORK? ❑ NO ❑YES-#of Devices: SELECT SCOPE(REQUIRED): ❑ Data ❑ Intercom ❑✓ Thermostat ❑Audio ❑ Secure Access ❑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. ❑ Other(List All): '2';''retteNCE y\ IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: ✓n NO El 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. ARE YOUAN OWNER PERFORMING WORK AS THE CONTRACTOR WITHOUT ELECTRICAL LICENSURE: ENO EYES-See Below&Pg. 3 n 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. CONTACT INFORMATION OWNER NAME: Dennis Miller TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET 2702 59th ST SW CITY Everett STATE WA ZIP 98203 OWNER PHONE:443 845-9890 OWNER EMAIL: CONTRACTOR NAME: Always Current Electric Inc CONTRACTOR ADDRESS: STREET720 N 10th St Suite A 403 CITY Renton STATE WA ZIP 98057 CONTRACTOR PHONE:206 793-7920 CONTRACTOR EMAIL:rance@alcuelectric.com CONTRACTOR LIC.#(REQUIRED):ALWAYCE843QB CITY OF EVERETT BUSINESS LIC.#(REQUIRED):567460 PRIMARY CONTACT: DOWNER ❑✓CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:206 793-7920 Rance CONTACT EMAIL:rance@alcuelectric.com AGREEMENT:I 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 state or local law regulating construction or the performance of construction. That I am authorized by the owner of this property to perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only PERMIT #: y� Rance Pedersen 3/7/2019 ` '� 6/63-055 Owner/Authorized Agent Signature Date (Revised 1/11/2019) Page 1-Application