1901 W MUKILTEO BLVD 2020-02-24 - Laserfiche WebLink

Ii L1.ECTRICAL PERMIT APPULATION EVERETT CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 WASHINGTON (P)425-257-8810 I FAX 425-257-8857 l(E)everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 1901 W. Mukilteo Blvd. _BUILDING AREA: 2968 sq ft PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ADDITION ❑TENANT IMPROVMENT ®REMODEL BUILDING USE: Q SFR ❑TOWNHOUSE ❑DUPLEX El ADU ❑ MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL ELECTRICAL APPLICATION INFORMATION &DESCRIPTION OF WORK CONTRACT PRICE OF WORK:$ 0 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: Disconnect and reconnect existing furnace THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ❑ NO ©YES-Select Scope:❑Service El Feeder 71 Circuits-#:1 ❑Complete Re-wire LOW VOLTAGE WORK? El NO ©YES-#of Devices:1 SELECT SCOPE(REQUIRED): El Data ❑ Intercom ✓❑Thermostat El Audio El Secure Access ❑ Security System ❑ 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. Cl Other(List All): CODE CO;MPLIANC! IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: © NO n 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. t ARE YOU AN OWNER PERFORMING WORK AS THE CONTRACTOR WITHOUT ELECTRICAL LICENSURE: ONO OYES-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: Richard & Suzanne Scriven TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET 1901 W Mukiltea Blvd CITY Everett STATE WA zip 98203 OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: Premier Mechanical & Electric CONTRACTOR ADDRESS: STREET22118 20th Ave SE Suite 125 CITY Bothell STATE WA aP 98021 CONTRACTOR PHONE:206-856-0079 CONTRACTOR EMAIL:contact@premierme.net CONTRACTOR LIC.#(REQUIRED):PREMIME9218G CITY OF EVERETT BUSINESS LIC.#(REQUIRED):47445 PRIMARY CONTACT: DOWNER ©CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:206-856-0079 Matt Clements Jr. CONTACT EMAIL:mattc@premierme.net 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 1 am authorized by the owner of this property to perform the work for which application Is made and 1 comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only PERMIT#: Owner/Authorized Agent Signature Date (Revised 1/11/2019) Page 1-Application