2215 MAIN ST 2020-01-30 - Laserfiche WebLink

/1g''_„ ELECTRICAL PERMIT APPLICATION ,l11r'� 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 7>� �*' „ . apse 1'1 4a ''ai. R T;. ITE JNFO �, � & .� �..� PROJECT ADDRESS: 2215 MAIN ST BUILDING AREA: 1520 sq ft PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ADDITION ❑TENANT IMPROVMENT © REMODEL BUILDING USE: ©SFR ['TOWNHOUSE ❑ DUPLEX ❑ADU ❑ MULTI-FAMILY-#OF UNITS: ❑ COMMERCIAL CONTRACT PRICE OF WORK:$ 1500 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: ADD CIRCUIT FOR HEAT PUMP INSTALLATION - PANEL UPGRADE - THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? © NO ❑YES-Select Scope: ©Service ❑ Feeder ©Circuits-#: 1 ❑Complete Re-wire LOW VOLTAGE WORK? ❑✓ NO ❑YES-#of Devices: SELECT SCOPE(REQUIRED): Cl Data ❑ Intercom ©Thermostat ❑Audio ❑ 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); IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: CJ NO ■ 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. tt;;ii ARE YOU AN OWNER PERFORMING WORK AS THE CONTRACTOR WITHOUT ELECTRICAL LICENSURE: PING DYES-See Below&Pg, ""— 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. T■■■■ 2{ 55 OWNER NAME: ANDREW DAVIDSON TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET 2215 MAIN ST CITY EVERETT STATE WA ZIP 98203 OWNER PHONE:715-781-4184 TOWNER EMAIL:rubbersideup07@gmail.com CONTRACTOR NAME: C.M. HEATING INC CONTRACTOR ADDRESS: STREET 1415 BROADWAY CITY EVERETT STATE WA ZIP 98201 CONTRACTOR PHONE:425-259-0550 JCONTRACTOR EMAIL:KAILANA@CMHEATING,COM CONTRACTOR LIC.*REQUIRED): CMHEAMH877DN ICTTY OF EVERETT BUSINESS LIC.#(REQUIRED): 016098 PRIMARY CONTACT: DOWNER ©CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:425-259-0550 KAI LANA CONTACT EMAIL:KAILANA@CMHEATING.COM ;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 I comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only PERMIT# rc4L4L /f,) ccs/ 05/06/19 E `ic3kOS v 3 Owner/Authorized Agent Signature Date (Revised 1111l7019) Page 1-Application