1802 DULL PL 2020-02-06 - Laserfiche WebLink

I L.ECTRICAL PERMIT APPLIL TION OLTCITY 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 PROJECT SITE INFORMATION PROJECT ADDRESS: 1802 Dull PI BUILDING AREA: 2200 sq ft PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ADDITION ❑ TENANT IMPROVMENT ✓❑ REMODEL BUILDING USE: ❑✓ SFR ❑ TOWNHOUSE ❑ DUPLEX ❑ADU ❑ MULTI-FAMILY-#OF UNITS: ❑ COMMERCIAL ELECTRICAL APPLICATION INFORMATION & DESCRIPTION OF WORK CONTRACT PRICE OF WORK: $ / ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: Install Main Disconnect next to Meter. Install new electrical panel. Rewire original portion of the property to eliminate ungrounded circuits. Add circuits in kitchen to bring up to code. Install tamper proof outlets and gfi's where required. Add recessed lighting throughout. Install AFCI/GFCI breakers where required. THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ❑ NO ❑YES-Select Scope: ❑✓ Service ✓❑ Feeder ❑ Circuits-#: ❑✓ Complete Re-wire LOW VOLTAGE WORK? ❑ NO ❑YES-#of Devices: SELECT SCOPE(REQUIRED): ❑ Data ❑ Intercom ❑ Thermostat ❑Audio El Secure Access ❑ 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. ❑ Other(List All): Y•OKIWA"" � CG: .�3MPLIANCE ,,.--.:++7�� .,`�. ' IS THIS PERMIT EDUCATION, INSTITUTIONAL, HEALTH AND/OR PERSONAL CARE FACILITIES: ❑✓ NO U 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. EYES ARE YOU AN OWNER PERFORMING WORK AS THE CONTRACTOR WITHOUT ELECTRICAL LICENSURE: ENO IJYES-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 1-1 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 INFORMATION OWNER NAME: Nicholas Lusch TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET 1802 Dull PI CITY Everett STATE WA ZIP 98203 OWNER PHONE:954-854-9056 OWNER EMAIL:nicklusch@yahoo.com CONTRACTOR NAME: Du mr -- CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LIC.#(REQUIRED): CITY OF EVERETT BUSINESS LIC.#(REQUIRED): PRIMARY CONTACT: ['OWNER ❑CONTRACTOR EOTHER(Please Specify) CONTACT NAME: CONTACT PHONE: (f S -./.5c- cls 5T- CONTACT EMAIL: ,c}- I.. c // �>>' °14..1 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#: E MC r. -' 1 ( OwnerfAuthorized Agent Signature Date (Revised 1/11/2019) Page 1-Application EL.0! -1# L.. N n/.D &.-SK-C)