1610 EDGEMOOR LN 2020-02-06 - Laserfiche WebLink

ELECTRICAL PERMIT APPLICATION EVERETT CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 WASHINGTON (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 1610 Edgemoore Ln IL BUILDING AREA: sq ft PROJECT TYPE: LI NEW CONSTRUCTION ❑ADDITION LLTENANT IMPROVMENT ❑ REMODEL BUILDING USE: SFR El TOWNHOUSE LI DUPLEX ❑ADU ❑ MULTI-FAMILY-#OF UNITS: ❑ COMMERCIAL ELECTRICAL APPLICATION INFORMATION & DESCRIPTION OF WORK CONTRACT PRICE OF WORK:$ 350 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: FURNACE CHANGE OUT ADD AC THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT PPLY) LINE VOLTAGE WORK? ❑ NO ❑ YES-Select Scope: ❑ Service ❑ Fe der 7 Circuits-#: ❑ omplete Re-wire LOW VOLTAGE WORK? ❑ NO ❑ YES-#of Devices: SELECT SCOPE(REQUIRED): ❑ Data ❑ Intercom ®Thermostat ❑Atgio ❑ Secure - ss ❑ Security System ❑ Fire Alarm-Installations under this permit only include efe'CtrtCaf wiring rough-in of the system.An additional Fire Alarm Permit is required for review of device location and installation approval. ❑ Other(List All): CODE COMPLIANCE IS THIS PERMIT EDUCATION, INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: ® NO El 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 EYES-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 INFORMATION OWNER NAME: Bud Wagner TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET 1610 Edgemoore Ln CITY fadv6 d ev`V.e•t STATE WaZIP ITL 2130.61.- OWNER PHONE: 425-238-1994 OWNER EMAIL: BUDMIEW@COMCAST.NET CONTRACTOR NAME: CONTRACTOR ADDRESS: STREET 18103 NE 68TH ST SE, C-200 CITY REDMOND STATE WA ZIP 98052 CONTRACTOR PHONE: 425-881-7920 CONTRACTOR EMAIL: PERMITS@MMCOMFORTSYSTEMS.COM CONTRACTOR LIC.#(REQUIRED): MMCOMCS839PT CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 055245 PRIMARY CONTACT: ❑OWNER CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 425-629-1025 Jenah Barlow CONTACT EMAIL: PERMITS@MMCOMFORTSYSTEMS.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 wit the State Contractors Law 18.27 RCW and 296.200 WAC, City of Everett Official Use Only PERMIT#: (� -\q - E OvJner/A t' •rize. •gent Si. . ure Date (Revised 1/11/2019) Page 1-Application