4924 CHINOOK DR 2020-01-22 - Laserfiche WebLink

ELECTRICAL PERMIT APPLICATION EVERETT CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 WASHINGTON (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov( www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 4924 Chinook Dr BUILDING AREA: N/A sq ft PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ADDITION ❑ TENANT IMPROVMENT El REMODEL BUILDING USE: E SFR E TOWNHOUSE ❑ DUPLEX ❑ ADU ❑ MULTI-FAMILY-#OF UNITS: ❑ COMMERCIAL ELECTRICAL APPLICATION INFORMATION & DESCRIPTION OF WORK CONTRACT PRICE OF WORK:$ 1650 ASSOCIATED BUILDING PERMIT#(if applicable); B1907-010 DESCRIBE SCOPE OF WORK: Install 50amp Circuit, disconnect and hookup of new owner supplied hot tub. 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? El 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): 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 296-468-900,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:Cheryl &Jeff Christensen TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET 4924 Chinook Dr CITY Everett STATE WA ZIP 98203 OWNER PHONE:(425) 327-6603 OWNER EMAIL:CtC4924@yahoo.com CONTRACTOR NAME: Full Spectrum Design CONTRACTOR ADDRESS: STREET4859 Alpine Drive CITY Everett STATE WA Z,P 98203 CONTRACTOR PHONE:425-330-5469 CONTRACTOR EMAIL:fullspectrumdesign@hOtmail.com CONTRACTOR LIC.#(REQUIRED):FULLSD*044KG CITY OF EVERETT BUSINESS LIC.#(REQUIRED):028519 PRIMARY CONTACT: DOWNER ❑CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:(425) 327-6603 Cheryl Oh ri ste(CONTACT EMAIL:ctc4924@yahoo.com AGREEMENT't 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* OILAr 61/0, 19 Elq *- \_62o Owner/Authorized Agen Sig ure Date (Revised 1/11/2019) Page 1-Application