1415 WETMORE AVE 2020-01-30 - Laserfiche WebLink

YA ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES EVERETT 3200 CEDAR STREET,EVERETT,WA 98201 ASH Noon (P)425-257-8810 FAX 425-257-8857 1(E)everetteps©everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 1415 Wetmore Ave BUILDING AREA: sq ft PROJECT TYPE: ❑NEW CONSTRUCTION ❑ADDITION ❑TENANT IMPROVMENT ❑REMODEL BUILDING USE: ®SFR El TOWNHOUSE El DUPLEX ❑ADU ElMULTI-FAMILY-#OF UNITS: ❑COMMERCIAL ELECTRICAL APPLICATION ,,.TION DESCRIPTION OF WORK . CONTRACT PRICE OF WORK:$ 4490. ASSOCIATED BUILDING PERMIT#(if applicable): fl") iCif DESCRIBE SCOPE OF WORK: retro t-stat and reconnect furnace THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? El NO El d YES-Select Scoe Service Feeder El Circuits-#: El Comptete Re-wire ° LOW VOLTAGE WORK? El NO E✓ YES-#of Devices: SELECT SCOPE(REQUIRED): ❑Data ❑ Intercom ✓❑Thermostat El Audio El Secure Access El Security System El 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. E Other(List All): CODE COMPLIANCE IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: 0 NO MI YES--See Below&Pg.2 By checking this box,I am stating that I have read and understand all of WAC 296-468-900,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: ENO ®YES-See Below&Pg.3 ❑ 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. CONTACT T INF I OWNER NAME: Mary Murphy TENANT BUSINESS NAME(if Commercial): OWNER MAILING ADDRESS: STREET 1415 Wetmore Ave cm, Everett STATE WA zip 98201 OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: Nordstrom Heating &Air CONTRACTOR ADDRESS: STREET4717 87th Ave NE crry Marysville STATE WA ZIP 98270 CONTRACTOR PHONE:360-386-9819 CONTRACTOR EMAIL:office@nordstromheating.com CONTRACTOR LIC.#(REQUIRED):nordsha975kh CITY OF EVERETT BUSINESS LIC.#(REQUIRED):042741 PRIMARY CONTACT: DOWNER E✓CONTRACTOR ❑OTHER(Please Specify) - _^ CONTACT NAME: CONTACT PHONE:360-386-9819 Debbie or Cheryl CONTACT EMAIL:office@nordstromheating.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 comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only PERMIT#: 1 — "— E (kc_c Owner/Authorized Agent Signature Date 7=11/2019)11/2019) Page 1-Application