2706 TAYLOR DR 2020-01-30 - Laserfiche WebLink

OCT-18-2019 11:10 FROM:MAT NNOOD 2067891834 I:4253492298 P.2 ELECTRICAL PERMIT APPLICATION E V ER E T T CITE'Or EYEliETr PERMri SFRVIGES 3201)CEDAR STREET,EVERETT,WA OB201 WASH LYON (P)42S-257-atm I FAX 425.2 -aa57 !(E)everettepn overettwe-gov l ww, wavereerwa.govrpermita ":PROJE 9 ITEM FOR q r PROJECT ADDRESS: 706 /,r(1 / „ iV£ BUILDING AREA: sq ft PROJECT TYPE: 0 NEW CONSTRUCTION El ADDITION ❑TENANT IMPROVMENT tdL1 REMODEL BUILDING USE: ®SFR 0OWT NHOUSE ❑DUPLEX ❑ADU El MULTI-I=AMILY-#OF UNITS; 0 COMMERCIAL MCT .A Pl WOA ioNlNf+ ` r TIO =' E • CONTRACT PRtC$OF WORK:$ /, $QQ'°12 ASSOCIATED BUILDING PERMIT/#(if applicable): DESCRIBE SCOPE OF WORK:t i +c) .at `fG.cZ Co cx.r ice' THIS INCLUDES THE FOLLOWINGtSCOPE:(SELECT ALL THAT APPLY) LINE VOLTAGE WORK? 0 NO L25I YES-9eirrct scopf2g..ServIco 0 reader El Ctrcult6-# El Complete Re-wire LOW VOLTAGE WORK? 'NO ❑YES- of Devices; SELECT SCOPE(REQUIRED): ❑Data ❑Intercom ❑Thermostat 0 Audio 0 5ecuro Access El Security System El Flro Alarm-Installations under this permit only Include electrical wiring rough•In of the syytam.An additional Firm Alarm Permit is required for review of device location and Installation approval. Ca Other(List Alp): C i ;iv ' -..•';1 OPW.Ca v: •L A r-�., �. ,, way •gyp IS THIS PERMIT EDUCATION.INSTITUTIONAL HEALTH AND/OR PERSONAL CARE FACILITIES: li NO ■ YES—See$elow&P9.2 Ey checking hila box,I am stating that I have road and understand all of WAC 2O6•4aB-000, :•iect.d 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 Pape 2 require Plan Review. ARE YOUAN OWNER PERFORMING WORK AS THE CONTRACTOR WITHOUT ELECTRICAL LICENSURE; NO YES-Soo Below&Pg.3; nPursuant to RCW 19.28,281,property owners and leaseholders cannot perform electrical work on buildings for rent,sale,or lease without the proper electrical licensing end certification,or exemption.By Checking thla box,I am stating that I have Completed and See Pap,3 signed the AFFIDAVIT on page 3 of this application to receive an exemption from this licensing/certification requirement. ','`silo ,ia '7FISVMPAIlAt . N /M�e++a� II�� OWNER NAME: o )Q ':►• VC. TENANT RUBINESS NAME(If Commercial):. OWNER MAIL tN(i ADDRESS: cnzzr 766 • A. ` cm( l/!i;�ltr el�rtt 49/__as j g- V.3 OWNER PHONE: _ .,..:........_.. ..�........ OWNER EMAIL; CONTRACTOR NAME: ez CONTRACTOR ADDRESS. sntE2r "•�'•"� _,„_.-- „�.. orrr • arm as CONTRACTOR PHONE: CONTRACTOR EMAIL: �. CONTRACTOR LIC„#REQUIRED .-.. ..:.._... ....., CITY OF r"VERE-I"f'RU8tNE88 LfG,#REQUIRED: PRIMARY CONTACT: DOWNER ©CONTRACTOR EOThiER(Please Specify), CONTACT NAME: CONTACT PHONE: .z c%. 3f7 7 - Ali CONTACT EMAIL: AG- EMENT! -robs ) that ve read e .exentin•. a ltatkur and know the seine •.a true a •aorracL • pro •.ria of laws a Ordinance;guvernkif title type of work will Lie completed whether apeoblld harem orncr. The grant)ng of a patina doom not preawno to give authority to vtolaty on:envoi the provls(ons 0f soy other Stall or loom law regulating conatrvcrkxr or the perfomranae of conetructioh. That/um authorized by(he owner of this property to peat rm the wa*for which apprkreApp.q nada and comely with the State Contractors Lew 75.27 RCW and 295.200 WAC. Cl1 ce{terott Official Usepen,ririk Ort EOwl,:, �.,. /O 4. l , ' • y;1.r7`* ., 81. Data, Themed 1/1f/20?9TPage 1•Appilut on