2023 HOYT AVE 2020-01-29 - Laserfiche WebLink

.477. ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVEREI I,WA 98201 (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I wl w.everettwa.gov/permits 40F INV? :, . PROJECT SITE INFORMATION , PROJECT ADDRESS: 2023 HOYT AVE BUILDING AREA: 840 sq ft PROJECT TYPE: El NEW CONSTRUCTION ✓I ADDITION El TENANT IMPROVMENT ❑ REMODEL BUILDING USE: N SFR El TOWNHOUSE El DUPLEX El ADU ❑MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL ELECTRICAL APPL1C TIQ$lNFORMATIONit&DESCRIPTIoNFoF YORK CONTRACT PRICE OF WORK:$ 3074"03 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: 80 TO 80 SWAPOUT AND AIR CLEANER INSTALLATION THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ❑ NO ❑YES-Select Scope: El Service ElFeeder 0 Circuits-#:2 ❑Complete Re-wire LOW VOLTAGE WORK? 1✓ NO El YES-#of Devices: SELECT SCOPE(REQUIRED): ❑ Data ❑ Intercom ❑Thermostat El Audio El Secure Access El 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. I:Other(List All): COMPLIANCE;t IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: D NO Q 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: ZNO EYES-See Below&Pg.3 Pursuant to ROW 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: BOBS! MALONE TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: sTREE' 2023 HOYT AVE EVERETT STATE WA zip 98201 OWNER PHONE:425-478-5632 OWNER EMAIL:BOBBIEMALONE44@GMAILCOM CONTRACTOR NAME: gs heating CONTRACTOR ADDRESS: srRE_'3409 eVerett eve everett STATE wa ZIP 98201 CONTRACTOR PHONE:425-6104257 CONTRACTOR EMAIL:MELANIE@GSHEATING.COM CONTRACTOR LIC.#(REQUIRED):GSHEAHC8218R CITY OF EVERETT BUSINESS UC.#(REQUIRED): 60058 PRIMARY CONTACT: 00VVNER ECONTRACTOR EOTHER(Please Specify) CONTACT NAME: CONTACT PHONE:425-610-4257 MELANIE MENDENHALL CONTACT EMAIL:MELANIE@GSHEATING.COM AGREEMENT I hereby certify that I have read and examined this application and know the same to be true and correct. Ai!provisions of taws 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: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 P.CW and 296.200 WAC. City of Everett Official Use Only PERMIT#: MELANIE MENDENHALL 1014P)/(9 E 1 OwnerlAuthorized Agent Signature Date (Revised 1/11/2019) Page 1-Application