5904 FLEMING ST 2020-02-07 - Laserfiche WebLink

E-CTRICAL PERMIT APPLIONTION EVERETT CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 WASHINGTON (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits .{ T T MAST u PROJECT ADDRESS: 5904 Fleming Street, Everett WA 98203 BUILDING AREA: 2500 sq ft PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ADDITION ❑TENANT IMPROVMENT ✓❑ REMODEL BUILDING USE: ❑✓ SFR El TOWNHOUSE ❑ DUPLEX ❑ADU ❑ MULTI-FAMILY-#OF UNITS: ❑ COMMERCIAL 7 -- ELEC RI L PIPLL z A��7"f0. l FO'R A rr 7 ESRC P' 1 P O a, r= {:-_,. ..� I r€-�..�. r.�:-<-��'''€� �.: ,Aa2t" � >.. � �� _: �, , a :,o..�_ +oma:, .` CONTRACT PRICE OF WORK: $ 100 ASSOCIATED BUILDING PERMIT#(if applicable): N/A DESCRIBE SCOPE OF WORK: Re-Install Heat Pump ._ 2.ef ON,lgj(2,_ COV 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):Heat Pump IS THIS PERMIT EDUCATION, INSTITUTIONAL, HEALTH AND/OR PERSONAL CARE FACILITIES: ✓❑ NO • 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 YOUAN OWNER PERFORMING WORK AS THE CONTRACTOR WITHOUT ELECTRICAL LICENSURE: ❑✓ NO EYES-See Below&Pg.3 nPursuant 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. AIMPAL � :^u �."�`, i;r�i €.: e� �'�;- 414:11,140H010100:041141 'idN'.�i ��i�tiP�� si�9l� i��69�� IPC €."� ;�;"�` I '� �, ` m � .., � OWNER NAME: Anthony Scott TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET 5904 Fleming Street c,n Everett STATE WA Z,P 98203 OWNER PHONE:206-669-5886 OWNER EMAIL:scottanthonyeino@gmail.com CONTRACTOR NAME: Owner, as above CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LIC.#(REQUIRED): CITY OF EVERETT BUSINESS LIC.#(REQUIRED): yu PRIMARY CONTACT: DOWNER ❑CONTT RACTOO R ['OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:206-669-5886 Anthony Scott CONTACT EMAIL:scottanthonyeino@gmail.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 C tors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only PERMIT#: 07/29/19 E Ow Authorized Agent Signature Date (Revised 1/11/2019) Page 1-Application