130 E MCGILL AVE 2020-01-30 - Laserfiche WebLink

IlitECTRICAL PERMIT APPLIPITION CITY OF EVERETT PERMIT SERVICES EVERETT 3200 CEDAR STREET,EVERETT,WA 98201 WASHINGTON (P)428-257-8810 I FAX 425-257-8857 1(E)everettepseeverettwa.gov I www.everettwa.gov/perrnits 7,,,03474,1rZ,Vr - w-t° . • * PROJECT ADDRESS: 130 E McGill Ave BUILDING AREA: sq ft PROJECT TYPE: 0 NEW CONSTRUCTION 0 ADDITION 0 TENANT IMPROVMENT El REMODEL BUILDING USE: 0 SFR 0 TOWNHOUSE El DUPLEX 0 ADU El MULTI-FAMILY.-#OF UNITS: El COMMERCIAL :14441-1-1,AARIAT CONTRACT PRICE OF WORK:$ ' •86.26 °• f-*/ ASSOCIATED BUILDING PERMIT#(If applicable): M1012-002 DESCRIBE SCOPE OF WORK: retro t stat and reconnect furnace THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE:(SELECT ALL THAT APPLY) LINE VOLTAGE WORK? 0 NO 0 YES-Select Scope:0 Service 0 Feeder• E Circuits-ft: ID Complete Re-wire LOW VOLTAGE WORK? El NO El YES-#of Devices: SELECT SCOPE(REQUIRED): CI Data 0 Intercom 0 Thermostat 0 Audio El Secure Access 0 Security System 0 Fire Alarm-Installations under this permit only include electrical wiring rough-in of the system.Art additibnal Fire Alarm Permit is required for review of device location and installation approval. • 0 other(List All): IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: NO 111 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: NO DYES-See Below&Pg.3 ri Pursuant to RCW 19.28.261,property owners and leaseholders cannot perform electrical work on buildings for rent,sale,or lease Lj 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 an page 3 of this application to receive an exemption from this licensing/certification requirement. A.;',?-f,J1'f:vi;,;tit%"MPZTAIW3Tzlgfra:X-.7trasl;V9:1171TTlrrirVi iTrAfai4VATIErslit-4. 414:102.17,c4ittiAr4rA, tate...;104.; , OWNER NAME: Keith Ebensteiner TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: sTREET 130 E McGill Ave Everett STATE WA zip 98208 OWNER PHONE:425-760-1830 OWNER EMAIL: CONTRACTOR NAME: Nordstrom Heating and Air CONTRACTOR ADDRESS: sTREeT4717 87th Ave NE cify Marysville STATE WA a 98270 CONTRACTOR PHONE:360-386-9819 CONTRACTOR EMAIL:nordstromha@comcast.net CONTRACTOR LIC.#(REQUIRED):nOrdsha8841w JCITY OF EVERETT BUSINESS LIC.#(REQUIRED):042741 PRIMARY CONTACT: DOWNER ['CONTRACTOR DOTHER(Please Specify) CONTACT NAME: CONTACT PHONE:360-386-9819 Cheryi CONTACT EMAIL:nordstrornha@comcast.net 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 comply with the State Contractors Law 18.27 RCW and 296.200 WAG. City of Everett Official Use Only. PERMIT#: Cheryl McClellan 12/02/19 E j12 — 0 CH' owner/Authorized Agent Signature Date (Revised 1/11/2019) Page I-Application