2431 HARRISON AVE 2020-01-29 - Laserfiche WebLink

ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 ,'(E)everetteps@everettwa,gov I www,everettwa.gov/permits OLT PROJECT SITE;INFORMATION. ,.., PROJECT ADDRESS: 2431 HARRISON AVE BUILDING AREA: sq ft PROJECT TYPE: ❑NEW CONSTRUCTION (:1 ADDITION ❑TENANT IMPROVMENT El REMODEL BUILDING USE: C✓]SFR ❑TOWNHOUSE ❑DUPLEX CI ADU El MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL ELEC,TRICAPAPPLICA.TION;INFORMATION &';DESCRIPTION OF WORK' CONTRACT PRICE OF WORK:S.)00( 2b0°% ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: DUCTLESS HEAT PUMP INSTALLATION THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ❑NO El YES-Select Scope:El Service ❑ Feeder ©Circuits-#:1 El Complete Re-wire LOW VOLTAGE WORK? El NO El YES-#of Devices: SELECT SCOPE(REQUIRED): ❑ Data El Intercom El 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 All): CODE COMPLIANCE�:. . ',',",-;,'!- ISJ .,a.. .: .. F �'n .. _ >r .., .. -' ... .v. .. � ,.Y .)l4� 4 ,. r ._, r: IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: ✓l NO Li 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: ONO 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: DANIEL MEINS TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: sTREEr 2431 HARRISON AVE crrr EVERETT STATE WA ZIP 98201 OWNER PHONE:4253156801 OWNER EMAIL;INSTALL@GSHEATING.COM CONTRACTOR NAME: gS heating CONTRACTOR ADDRESS: STREET3409 everett ave tarn, everett STATE WB z,P 98201 CONTRACTOR PHONE:425-2524402 CONTRACTOR EMAIL:ALISHA@gsheating.com CONTRACTOR LIC.#(REQUI RED):GSHEAHC8218R CITY OF EVERETT BUSINESS LIC.#(REQUIRED):60058 PRIMARY CONTACT: DOWNER :CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:425-252-4402 ALISHA CLOGSTON CONTACT EMAIL:ALISHA@gsheating.com AGREEMENT:I hereby certify that 1 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 l 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#:E ALISHA CLOGSTON 'I ). 1 / Dl'` Owner/Authorized Agent Signature Date (Revised 1/11/2019) (P59 1-Application