1215 118TH PL SE 2020-01-23 - Laserfiche WebLink

cLECTRICAL PERMIT APPLI ,HTION E V E R E T T 32CITY OF EVERETT PERMIT SERVICES 00 CEDAR STREET, EVERETT,WA 98201 WASHINGTON (P)425-257-8810 I FAX 425-257-8857 1 (E)everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 1215 118th PL SE 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: $ 600 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: Adding 2 new circuits - 1 for a new air-conditioner and 1for a new tankless water heater THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ❑ NO ❑✓ YES-Select Scope: ❑ Service ❑ Feeder ❑✓ Circuits-#:2 El 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 El 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: ENO DYES-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: Trent Stoker TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET 1215 118th PI SE CITY Everett STATE WA ZIP 98208 OWNER PHONE:253-561-1651 OWNER EMAIL: CONTRACTOR NAME: Sundance Energy Services CONTRACTOR ADDRESS: sTREET224 192nd St SW CITY Bothell STATE WA ZIP 98012 CONTRACTOR PHONE:425481-9660 CONTRACTOR EMAIL:sundanceenergy1@msn.com CONTRACTOR LIC.#(REQUIRED):sundaes062j8 CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 32052 PRIMARY CONTACT: ❑OWNER ✓❑CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: CONTACT EMAIL: 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 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 St. - on actors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only PERMIT#: E \6-t �' �►l �I 7-19-2019 Owner/Author,zed Ages Signature Date (Revised 1/11/2019 Page 1-Application