2124 LEXINGTON AVE 2020-01-30 - Laserfiche WebLink

... . ill ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES EVERETT 3200 CEDAR STREET,EVERETT,WA 98201 WASHINGTON (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps@everettwa.gov 1 www.everettwa.gov/permits a M A!.'3Vi : PROJECT ADDRESS: 2.12y, texilile / elvencl.t 5 e,dC- td ' van3IBUILDING AREA: sq ft PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ADDITION ❑TENANT IMPROVMENT ❑ REMODEL BUILDING USE: ❑SFR El TOWNHOUSE ❑ DUPLEX ❑ADU ❑MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL ..>.,. 4atiiU em-.a ° z,.,:.. St ..:.,. aPjo,a^\sca-,,,, .: .,44w':„.. a. s e� ' .. CONTRACT PRICE OF WORK:$ 2.0010 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: Add kfSrhe/ Sb / 4)o 1,64 / I( 6#1 THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? El NO RYES-Select Scope:❑Service ❑ Feeder ❑Circuits-#: ❑Complete Re-wire LOW VOLTAGE WORK? 5k.isio ❑YES-#of Devices: SELECT SCOPE(REQUIRED): El Data ❑ Intercom ❑Thermostat El Audio ❑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. ❑Other(List All): IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: 'NI NO • YES--See Below&Pg.2 I i By checking this box,I am stating that I have read and understand all of WAC 296-46B-900, -elected 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: (KM() DYES-See Below&Pg.3 ni I 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. OWNER NAME: tCA 1;/UOLL. TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET 2/Z 7 L.E2c1AU .6 TO N *.Jae Q cry eve. STATE W ZIP /(9203 OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: ECO 6/pie 77x 1 ELE? me CONTRACTOR ADDRESS: STREET j Q 7/7/Q/4/en c( o A t CITY (�/" STATE ZIP 98203 CONTRACTOR PHONE: 2-06 W6 4't77 CONTRACTOR EMAIL: LCtJ� 0 Cont." CONTRACTOR LIC.#(REQUIRED): •L/ E • •.�Z CITY OF EVER TT LIC.#(REQ IR 11 PRIMARY CONTACT: DOWNER CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 2,06_4, 4,6.- 'f(7 L)WW?(e( cor,cV CONTACT EMAIL: % eleed7,2• 5,14420. 660/71). AGREEMENT:I hereby certify that I have read and examined this application and know the same to be rue and orrect. All provisions of lawiaand ordinances governing this type of work will be completed whether specified herein or not. The granting of a permit does not presume to g e authority to violate or cancel the provisions of any other state or local law regulating co truction 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 At C. ctors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only PERMIT 1 ff/////' 06/0g/W7 E tti Owner : • ' • •'e ignature Date (Revised 1/11/2019) i Page 1-Application