7439 BEVERLY BLVD 2020-01-21 - Laserfiche WebLink

ELECTRICAL PERMIT APPLIRATION CITY OF EVERETT PERMIT SERVICES 44/WrA 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 1 FAX 425-257-8857 1(E)everetteps@everettwa,goy I www.everettwa.gov/permits PROJECT RITE INFORMA ION PROJECT ADDRESS: 7439 BEVERLY BLVD 'BUILDING AREA: 1650 sq ft PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ADDITION ❑ TENANT IMPROVMENT ❑✓ REMODEL BUILDING USE: ❑SFR ❑TOWNHOUSE ❑DUPLEX ❑ADU El MULTI-FAMILY-#OF UNITS: ❑✓ COMMERCIAL W' EL _CTRICAL [I . ; TION INFORMATION & DE-CRIPTIO OF WOR t CONTRACT PRICE OF WORK:$ 250 'ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: MODIFY CIRCUIT FOR HEAT PUMP SWAP OUT THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? © NO ❑YES-Select Scope: ❑Service ❑Feeder 0 Circuits-#:1 ❑Complete Re-wire LOW VOLTAGE WORK? ✓❑ NO ❑YES-#of Devices: SELECT SCOPE(REQUIRED): ❑ Data ❑ Intercom ©Thermostat ❑Audio El 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 AID: '415,417' CODE : > PLIANCE IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: IN NO El YES--See Below&Pg.2 f 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 OYES-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 r e � m aim r ' OWNER NAME: CHELSEA GILETTE TENANT BUSINESS NAME(If Commercial):., OWNER MAILING ADDRESS: STREET 7439 BEVERLY BLVD CITY EVERETT STATE WA ZIP 98203 OWNER PHONE:425-280-5614 OWNER EMAIL:fixinyouup@msn.com CONTRACTOR NAME: C.M. HEATING INC CONTRACTOR ADDRESS: STREET 1415 BROADWAY CITY EVERETT STATE WA ziE 98201 CONTRACTOR PHONE:425-259-0550 'CONTRACTOR EMAIL:KAILANA@CMHEATING.COM CONTRACTOR LIC.#(REQUIREDD: CMHEAMH877DN 'CITY OF EVERETT BUSINESS LIC.*REQUIRE()); 016098 PRIMARY CONTACT: DOWNER QCONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: /� /� CONTACT PHONE:425-259-0550 KAI LANA CONTACT EMAIL:KAILANA@CMHEATING.COM AGREEMENT:thereby certify Mat I have read and exa n ed this applicafioh and know the same to be free and Carted. Ah p7avitionc of laws-ails;0rrtinanoes 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 properly to perform the work for which application is made and I comply with the State Contractors Law 18;27 RCW and 296200 WAC, Otty of Everett Official Use Only PERMIT#: 74/4(:),411 05/10/19 E I(21 `,' (iyn 1 ) Owner/Authorized Agent Signature Date (Revised Viii201O) Pege 1.Appllcat on