1617 ENGLAND AVE 2020-02-06 - Laserfiche WebLink

Ins ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES EVERETT 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 I(E)everelteps@averettwa,gov I www,everettwa.goviperrnits WASHINGTON/ '77.7: 7717PRIVOIPTIMFOIF PROJECT ADDRESS: 1617 ENGLAND AVE EVERETT 98203 BUILDING AREA: sq ft PROJECT TYPE: El NEW CONSTRUCTION El ADDITION El TENANT IMPROVMENT El REMODEL BUILDING USE: El SFR El TOWNHOUSE El DUPLEX El ADU El MULTI-FAMILY-#OF UNITS0 COMMERCIAL zLECTR$C1LV ' TIONINFPREATION& oscatirrt. tot, AVVFi CONTRACT PRICE OF WORK:$ 800 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: ALT CIRCUIT FOR GFI AND BATH FAN. LIGHTING AND RECEPTACLE LIKE FOR LIKE UPGRADES, THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? El NO 171 YES-Select Scope:El Service El Feeder 0 Circuits-#:1 1".:]Complete Re-wire LOW VOLTAGE WORK? El NO El YES-#of Devices: SELECT SCOPE(REQUIRED): El Data CI Intercom 0 Thermostat 0 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. 0 Other(List All): IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: III NO UYES—See Below&Pg.2 1.--1 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 OYES-See Below&Pg.3 E Pursuant to ROW 1928.261,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. 1' INFORMATION':VettTaiggrar OWNER NAME: HEIDI SEIKALY TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET 1617 ENGLAND AVE „y EVERETT sTATE WA z,,„98203 OWNER PHONE:NA 'OWNER EMAIL:NA CONTRACTOR NAME: IN HOUSE ELECTRIC CONTRACTOR ADDRESS: STREET 1530 117th DR SE CITY LAKE STEVENS WA i,„ 98258 CONTRACTOR PHONE:4257603203 CONTRACTOR EmAiLKELSEY@INHOUSEELECTRIC.COM • CONTRACTOR LIC.tAREQUIRED):INHOUES952QG CITY OF EVERETT BUSINESS LIC.#(REQUIRED):044168 PRIMARY CONTACT: DOWNER DCONTRACTOR 00THER(Please Specify) CONTACT NAME: CONTACT PHONE:4257603203 KELSEY CONTACT EMAIL:KELSEY@INHOUSEELECTRIC.COM -4 AGREEMENT:I hereby certify that I have read and examined this application and know the same to be true and correct, Alf provisions of laws and ordinances governing this type of work will be completed whether so',' rain 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 ter sting construction or the•ierformanc of •nstruction. That I em authorized by the owner of this property to perform the work for which application is made and I comply h e State9fitractors :w 18 27 RC nil 96.200 WAC City of Everett Official Use Only PERMIT#: / 4772 0/49' Eig 0 ,heriAutharize.Agent Signature Date (Revised 1 ill/2019) Page 1-Application