7305 E HEATHER WAY 2020-01-29 - Laserfiche WebLink

MUM ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES EVERETT 3200 CEDAR STREET,EVERETT,WA 98201 WASHING TON (I")425-257-8810 i FAX 425-257-8857 1(E)everetteps@everettwa goy www everettwa govtpermits PROJECT SITE INFORMATION PROJECT ADDRESS: 7305 E Heather Way BUILDING AREA: sq ft PROJECT TYPE: Ll NEW CONSTRUCTIONFt./:1 ADDITION El TENANT IMPROVMENT LI REMODEL BUILDING USE: El SFR 71 TOWNHOUSE El DUPLEX 0 ADU LI MULTI-FAMILY-#OF UNITS: E COMMERCIAL ELECTRICAL APPLICATION INFORMATION & DESCRIPTION OF WORK CONTRACT PRICE OF WORK:$ 1000 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: 1 CIRCUIT FOR AC THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? El NO :!21 YES-Select Scope:7 Service CI Feeder E Circuits-#:1 El Complete Re-wire LOW VOLTAGE WORK? 7 NO (71 YES-#of Devices: SELECT SCOPE(REQUIRED). 17 Data El Intercom CI Thermostat El Audio E Secure Access 7 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. a Other(List All): CODE COMPLIANCE IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: El NO [Ti 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: DAVID WILLIAMS TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS; STREET 7305 E Heather Way cr., EVERETT swe WA z 98203 OWNER PHONE:206-396-0279 OWNER EMAIL: CONTRACTOR NAME: WASHINGTON ENERGY SERVICES CONTRACTOR ADDRESS: SI REST 3909 196TH ST SW city LYNNVVOOD STATE WA ,. 98036 CONTRACTOR PHONE:206-378-6613 CONTRACTOR EMAIL:HMCOORDINATORS@WASHINGTONENERGY.COM CONTRACTOR LIC,#(REQUIRED):WASHIES854NG CITY OF EVERETT BUSINESS LIC.#(REQUIRED):54773 PRIMARY CONTACT: —OWNER [kCONTRACTOR DOTHER(Please Specify) CONTACT NAME: CONTACT PHONE:206-378-6613 JO PELLETT CONTACT EMAIL:HMCOORDINATORS@WASHINGTONENERGY.COM. AGREEMENT I hereby certify that I hove lead and exaiinneri this applicatonand know the sante to be trtie and correct All prowsk;na of taws and ordinances gemming 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 WAD City of Everett Official Use Only PERIV111, ii 1 10/21/19 VL „. . OwnorIA --Agent Signature Date (kev*ek't VII/A)/9) Paget-Agebeateaff----- 11--?