2323 73RD ST SE 2019-11-15 - Laserfiche WebLink

ECTRICAL PERMIT APPLI TION CITY OF EVERETT PERMIT SERVICES "IIPImo' - 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 PROJECT SITE INFORMATION PROJECT ADDRESS: 2323 73rd ST SE Everett 98203 BUILDING AREA: sq ft PROJECT TYPE: El NEW CONSTRUCTION El ADDITION ❑TENANT IMPROVMENT ✓❑ REMODEL BUILDING USE: ❑✓ SFR ❑ TOWNHOUSE El DUPLEX El ADU Cl MULTI-FAMILY-#OF UNITS: El COMMERCIAL ELECTRICAL APPLICATION INFORMATION & DESCRIPTION OF WORK CONTRACT PRICE OF WORK:$ 800 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: (2) 20 amp circuit to refeeed kitchen circuits THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ❑ NO ❑✓ YES-Select Scope: ❑ Service El Feeder El Circuits-#:1 ❑ Complete Re-wire LOW VOLTAGE WORK? El NO ❑YES-#of Devices: SELECT SCOPE(REQUIRED): ❑ Data ❑ Intercom ❑ Thermostat El Audio El Secure Access El 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): CODE COMPLIANCE IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: El 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 YOU AN OWNER PERFORMING WORK AS THE CONTRACTOR WITHOUT ELECTRICAL LICENSURE: ENO EYES-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. CONTACT INFORMATION" OWNER NAME: Patricia Prieto TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET 2323 73rd ST SE CITY Everett STATE WA ZIP 98203 OWNER PHONE:na OWNER EMAIL:na CONTRACTOR NAME: In House Electric CONTRACTOR ADDRESS: sTREET1530 117th DR SE CITY Lake Stevens STATE WA ZIP 98258 CONTRACTOR PHONE:4257602303 CONTRACTOR EMAIL:Ihepermlts@gmall.COm CONTRACTOR LIC.#(REQUIRED):inhoues952gg CITY OF EVERETT BUSINESS LIC.#(REQUIRED):044168 PRIMARY CONTACT: ❑OWN ER ❑✓CONTRACTOR EOTHER(Please Specify) CONTACT NAME: CONTACT PHONE:4257603203 Kelsey CONTACT EMAIL:Ihepermlts@gmall.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 : .truction. 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 a d 29; :r AC. City of Everett Official Use Only / PERMIT#: / 3/ / /( E1003- On') Owne-Authori.-d •gent Sig . ure Date (Revised 1/11/2019) Page 1-Application