201 E BEECH ST B 2020-01-21 - Laserfiche WebLink

am ELECTRICAL PERMIT APPLICATION *EVERETT 32CITY OF EVERETT PERMIT SERVICES 00 CEDAR STREET, EVERETT,WA 98201 WASHINGTON (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 201 B E Beech ST BUILDING AREA: sq ft _ PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ADDITION ❑TENANT IMPROVMENT ❑ REMODEL BUILDING USE: ❑SFR ❑TOWNHOUSE ❑ DUPLEX ❑ADU ❑ MULTI-FAMILY-#OF UNITS: ❑ COMMERCIAL ELECTRICAL APPLICATION INFORMATION & DESCRIPTION OF WORK CONTRACT PRICE OF WORK:$ 350 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: AIR HANDLER AND HP ADD ON )THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APP,L4) 1 LINE VOLTAGE WORK? CI NO ❑YES-Select Scoped"❑Service CI Feeder s \ Circuits-#: Complete Re-wire LOW VOLTAGE WORK? ❑ NO ❑YES-#of DO es: �� SELECT SCOPE(REQUIRED): CI Data El6 Intercor ®Thermostat ❑Audio S$cure`ACCess ❑ Security System ❑ Fire Alarm-Installations under this •,-rmit only include electrical wiring rough-in of the system.An additional Fire Alarm Permit is required for revie 'of device location and installation approval. ❑Other(List All): %/ CODE COMPLIANCE IS THIS PERMIT EDUCATION, INSTITUTIONAL, HEALTH AND/OR PERSONAL CARE FACILITIES: ® NO ❑YES--See Below&Pg. 2 By checking this box, I am stating that I have read and understand all of WAC 296-46B-900,selected the specific reason on page 2 of this application(see next page),AND Plan Review is NOT required because I meet all of the following sub sections that do not See Page 2 require Plan Review. ARE YOU AN OWNER PERFORMING WORK AS THE CONTRACTOR WITHOUT ELECTRICAL LICENSURE: NO EYES-See Below&Pg.3 Pursuant to RCW 19.28.261, property owners and leaseholders cannot perform electrical work on buildings for rent,sale,or lease without the proper electrical licensing and certification,or exemption. By checking this box, I am stating that I have completed and See Page 3 signed the AFFIDAVIT on page 3 of this application to receive an exemption from this licensing/certification requirement. CONTACT INFORMATION OWNER NAME: Tera&Jason Rutherford TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET 201 B E Beech ST CITY EVE$ETT STATE wa ZIP 98203 OWNER PHONE: 425-879-2075 OWNER EMAIL: Teradwruth@hotmail.com CONTRACTOR NAME: MM COMFORT SYSTEMS CONTRACTOR ADDRESS: STREET 18103 NE 68TH ST SE, C-200 CITY REDMOND STATE WA ZIP 98052 CONTRACTOR PHONE: 425-881-7920 CONTRACTOR EMAIL: PERMITS@MMCOMFORTSYSTEMS.COM CONTRACTOR LIC.#(REQUIRED): MMCOMCS839PT CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 055245 PRIMARY CONTACT: CI OWNER 14cONTRACTOR EOTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 4255-629-10255 Jenah Barlow CONTACT EMAIL: PERMITS@MMCOMFORTSYSTEMS.COM AGREEMENT:I hereby certify that/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 reguling 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 th State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only PERMIT#. . ‘ ql(..o _ i,-T E no9 ,.\.(--22 Owner/Autho ize•Age Signature Date (Revised 1/11/2019) Page 1-Application