3311 WAVE DR 2020-01-30 - Laserfiche WebLink

Is ELECTalCAL PERMIT &PPL' f 9t•IM CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 (P)425-257-8810 1 FAX 425-257-8857 1(E)everetteps@everettwa.gov 1 www.everettwa.gov/permits . ::;:.fP�ROJECT SvTE NF.ORE N ATIO PROJECT ADDRESS: 3311 t4/a✓t; /e,ve .P.-v3e lei- Go, 'BUILDING AREA: L2.F�' sq ft PROJECT TYPE: 0 NEW CONSTRUCTION 0 ADDITION 0 TENANT IMPROVM9.i� RENT EMODEL BUILDING USE: E SFR 0 TOWNHOUSE 0 DUPLEX 0 ADU 0 MULTI FAMILY #OF UNITS: 0 COMMERCIAL ELECTRICAL APPLICATION.INFORMATION &.; ESC; IPTION 01 <WORK `: . CONTRACT PRICE OF WORK:$ ,ASSOCIATED BUILDING/ PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: �i e % rem,h( amt 01l `►es r ail 1'� e/ec 1C. n,✓- i ck'c elf _ lee /1�mi7- r'io©!' 11 i)t 4tefar e5 14/7 41 ..TC-rated o;��- d� �'eMov� W 5 � 4' MA 1 t L E1 c� !! b 73. V tale li,� 6 F1 or arc 4,1 r a� 1e2'v,r�(, per/tit/1 �,`3 e 6,re A-e'. No o �.� c-1,�l� � e Ctrc�tr ��vreI, r7z ��r;i or THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) �/S-Select Scope: 0 Service 0 Feeder !2 Circuits-#: 5 Complete Re-wire LINE VOLTAGE WORK? ® NO L��YE LOW VOLTAGE WORK? 0 NO OYES-#of Devices: SELECT SCOPE(REQUIRED): 0 Data 0 Intercom 0 Thermostat 0 Audio 0 Secure Access 0 Security System EllFire 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. 0 Other(List All): r:.:CODE COMPLIANCE`S IS THIS PERMITT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: 0 NO 0 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: ONO !EKES-See Below&Pg. 3 ErPursuant 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. CONTACI':INFORMATIO1V........_ . . OWNER NAME: ivIGUA' Leslagi TENANTBUSINESSNAME(If Commercial): OWNER MAILING ADDRESS: STREET 379 1 `>ar' A/C CITY LVC t/d STATE �A zip q323/40 3 OWNER PHONE: 14-2..5- q 3 1 4405- 'OWNER EMAIL /'1'' 1--e 0K lid t Ql 'COM CONTRACTOR NAME: CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: 'CONTRACTOR EMAIL: CONTRACTOR LIC.#(REQUIRED): (CITY OF EVERETT BUSINESS LIC.#(REQUIRED): PRIMARY CONTACT: II! •WNER m 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME�� L � CONTACT PHONE: (/}g 1, CONTACT EMAIL: AGREEMENT.-I hereby certify that I havad 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 thework of Efor whictt Oh pic licaatil n is made Use Only and I comply with the State Contractors Law 18.27 RCW and 296.200 WAC. PERMIT#: E i0,0_,-c)07--- -----------. , Owned, . orized Agent Signature Date (Revised 1/11/2019) (Page 1-Application1 1\ _i