2130 FAIRFAX AVE 2020-02-07 - Laserfiche WebLink

ELECTRICAL PERMIT APPLICATION EVERETT CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 WASNIeGTON (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.govlpormits PROJECT SITE'INFORMATION ,,., PROJECT ADDRESS: 2130 Fairfax AVE everett 98201 BUILDING AREA: sq ft S: PROJECT TYPE: ❑NEW CONSTRUCTION El ADDITION El TENANT IMPROVMENT ✓❑REMODEL BUILDING USE: ❑✓ SFR 0 TOWNHOUSE ❑DUPLEX ❑ADU ❑MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL - ELECTRICAL APPLICATION INFORMATION& DESCRIPTION'.OI1i WOR .,-,4s:,' CONTRACT PRICE OF WORK:$ 1850 ASSOCIATED BUILDING PERMIT#(if applicable): i.'.-;:,,i":"...''... m DESCRIBE SCOPE OF WORK: �: 200 amp panel change 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: ph SELECT SCOPE(REQUIRED):CI Data ❑Intercom ❑Thermostat El Audio ❑Secure Access CI Security System ,, ❑Fire Alarm-Installations under this permit only Include electrical wiring rough-in of the system.An additional Om Fire Alarm Permit Is required for review of device location and installation approval. `^, 0 Other(List All): ; '-' .'. CODE COMPLIANCE ' ,, IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: C:1 NO CI YES—See Below&Pg.2 i.::- C 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 IA\ r: of this application(see next page),AND Plan Review is NOT required because I meet all of the following sub sections that do not er: See Page 2 require Plan Review. ARE YOU AN OWNER PERFORMING WORK AS THE CONTRACTOR WITHOUT ELECTRICAL LICENSURE:ENO DYES-See Below&Pg.3 "; (—'J Pursuant to RCW 19.28261,property owners and leaseholders cannot perform electrical work on buildings for rent,sale,or lease f without the proper electrical licensing and certification,or exemption.By checking this box,I am stating that I have completed and .r See Page 3 signed the AFFIDAVIT on page 3 of this application to receive an exemption from this licensing/certification requirement. : .„V:-...rw CONTACT INFORMATION OWNER NAME: Erin Shaw TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET 2130 fair-fax ave cny everett STATE wa Zip 98201 OWNER PHONE:na OWNER EMAIL:na CONTRACTOR NAME: In House Electrical Services, Inc. n b: CONTRACTOR ADDRESS: sreLEr1530 117th DR SE a CRY Lake StevensSTATE WA z,98258 CONTRACTOR PHONE:4257603203 CONTRACTOR EMAIL:ihepermitsQ@gmall.COm CONTRACTOR LIC.#(REQUIRED):Inhoues952gg CITY OF EVERETT BUSINESS LIC.#(REQUIRED):044168 PRIMARY CONTACT: DOWNER ❑✓CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:4257603203 ; ke I s ey CONTACT EMAIL:kelsey@InhouseeleCtric.com € AGREEMENT:I hereby certify that I have read and examined this application and know the same to be true and canect. 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 lam authorized by the owner of this property to perform the work for which application Is made and I r comply wi I a State o. tractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only 1°(31( / / PERMIT#: Owner/AI I'ZJ ( 1 E \O l \ -N.j . \ .rlzed Agent Signature Date (Revised 1/11/2019) Page 1-Application :, Scanned with CamScanner