529 94TH ST SW 2020-01-23 - Laserfiche WebLink

ELECTRICAL PERMIT APPLICATION �!Y�•—� CITY OF EVERETT PERMIT SERVICES +43200 CEDAR STREET.EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 i(E)everetteps@everettwa gov www everettwa gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 529 94TH ST SW BUILDING AREA: 1132 sq ft PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ADDITION ❑TENANT IMPROVMENT El REMODEL BUILDING USE: ✓❑SFR El TOWNHOUSE ❑DUPLEX ❑ADU ❑ MULTI-FAMILY-#OF UNITS: El COMMERCIAL ELECTRICAL APPLICATIO INFORMATION & DESCRIPTION OF WORK CONTRACT PRICE OF WORK:$ 250 !ASSOCIATED BUILDING PERMIT#(if applicable), DESCRIBE SCOPE OF WORK: ADD CIRCUIT FOR 2 ZONE DUCTLESS SYSTEM INSTALL THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? Q NO E YES-Select Scope: ❑Service ❑ Feeder 71 Circuits-#:1 ❑Complete Re-wire LOW VOLTAGE WORK? ❑✓ NO ❑YES-#of Devices: SELECT SCOPE(REQUIRED): ❑Data ❑ Intercom El Thermostat ❑Audio ❑ 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 El Other(List All): CODE COMPLIANCE IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: NO E1 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" r ARE YOU AN OWNER PERFORMING WORK AS THE CONTRACTOR WITHOUT ELECTRICAL LICENSURE: [ZINO 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 INFOR AVON OWNER NAME: MICHAEL STEWART TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET 529 94TH ST SW civ EVERETT STATE WA Z,P 98204 OWNER PHONE:425-290-8044 OWNER EMAIL:mstewart28@fastmail.com CONTRACTOR NAME: C.M. HEATING INC CONTRACTOR ADDRESS: STREET 1415 BROADWAY oTv EVERETT STATE. WA ZIP 98201 CONTRACTOR PHONE:425-259-0550 CONTRACTOR EMAIL:KAI LANA@CMHEATI NG.COM CONTRACTOR LIC.#(REQUIRED): CMHEAMH877DN CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 016098 PRIMARY CONTACT: DOWNER (✓CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: Q LANA PHONE:425-259-0550 `AI LANA CONTACT EMAIL:KAILANA@CMHEATING.COM AGREEMENT /hereby certify that)have teed 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 t comply with the State Contractors Law 18.27 RCW and 296 200 WAG. City of Everett Official Use Only �j,, / )��,� / PERMIT#: /l /C ,l ,CQ/r!/1„t4 jet /- 07/11/19 E LO OwnerfAutharized Agent Signature Date '(Revised 1VI1P2O19) Page 1-Application