Laserfiche WebLink
IWCTRICAL PERMIT APPLIION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 1 FAX 425-257-8857 1(E)everetteps@everettwa.gov i www.everettwa.gov/permits <br /> 4rErr <br /> ;;1PR: JECT � R:INFORMAT 1 g <br /> PROJECT ADDRESS: 4719 Baker Dr BUILDING AREA: 3012 sq ft <br /> PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ADDITION ❑TENANT IMPROVMENT ✓❑ REMODEL <br /> BUILDING USE: ✓❑SFR ❑ TOWNHOUSE ❑ DUPLEX ❑ADU ❑ MULTI-FAMILY-#OF UNITS: ❑ COMMERCIAL <br /> ,,.. EWTRIICMAIMJLICATION INFO k,T' 914,& DESCRIPTION O WOR!C ,, <br /> CONTRACT PRICE OF WORK: $ 3600 ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIBE SCOPE OF WORK: <br /> 320AMP Service Upgrade and Panel Changes <br /> THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) <br /> LINE VOLTAGE WORK? ❑ NO 0 YES-Select Scope: 17 Service ❑ Feeder ❑ Circuits-#: ❑ Complete Re-wire <br /> LOW VOLTAGE WORK? ✓❑ NO ❑YES-#of Devices: <br /> SELECT SCOPE(REQUIRED): ❑ Data ❑ Intercom ❑Thermostat ❑Audio ❑ Secure Access ❑ Security System <br /> El Fire Alarm-Installations under this permit only include electrical wiring rough-in of the system.An additional <br /> Fire Alarm Permit is required for review of device location and installation approval. <br /> ❑Other(List All): <br /> ,CODE.,0" • NCE ' A st 7,:: <br /> IS THIS PERMIT EDUCATION, INSTITUTIONAL, HEALTH AND/OR PERSONAL CARE FACILITIES: ❑✓ NO ❑YES--See Below&Pg.2 <br /> — 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 <br /> — of this application(see next page),AND Plan Review is NOT required because I meet all of the following sub sections that do not <br /> See Page 2 require Plan Review. <br /> ARE YOUAN OWNER PERFORMING WORK AS THE CONTRACTOR WITHOUT ELECTRICAL LICENSURE: ✓❑NO EYES-See Below&Pg.3 <br /> ❑ Pursuant to RCW 19.28.261, property owners and leaseholders cannot perform electrical work on buildings for rent,sale, or lease <br /> without the proper electrical licensing and certification, or exemption. By checking this box, I am stating that I have completed and <br /> See Page 3 signed the AFFIDAVIT on page 3 of this application to receive an exemption from this licensing/certification requirement. <br /> .. ' ' ' ,COACT I ATIION , <br /> OWNER NAME: JIM Goldade TENANT BUSINESS NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 4719 Baker Dr <br /> c,T,, Everett STATE WA Z,p 98203 <br /> OWNER PHONE:4252996580 OWNER EMAIL:Jmgoldade@comcast.net <br /> CONTRACTOR NAME: Seatown Electric Corp. <br /> CONTRACTOR ADDRESS: STREET3431 Broadway <br /> cITY Everett STATE WA zip 98201 <br /> CONTRACTOR PHONE:206-905-4946 CONTRACTOR EMAIL:Permits@seatownservices.com <br /> CONTRACTOR LIC.#(REQUIRED):SEATOEC86ORB CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 53916 <br /> PRIMARY CONTACT: DOWNER ❑✓CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:425-270-1623 <br /> Bekah Swanson CONTACT EMAIL:permits@seatownservices.com <br /> 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 <br /> 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 <br /> 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 <br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only <br /> PERMIT#: <br /> (7 10/1/19 ` 0`�— O l 2___ <br /> Owner/Authoriz d A E Tc <br /> ent Signature Date (Revised 1/11/2019) Page 1-Application <br />