3025 OAKES AVE SNO CO JAIL 2020-02-24

ILECTRICAL PERMIT APPL ATION EVERETT 32CITY OF EVERETT PERMIT SERVICES 00 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 PROJECT SITE INFORMATION PROJECT ADDRESS: 30.2.S.- C)/4q45 AV& BUILDING AREA: sq ft PROJECT TYPE: LI NEW CONSTRUCTION El ADDITION El TENANT IMPROVMENT El REMODEL BUILDING USE: ❑SFR ❑Ti HO E El DUPLEX ❑ADU ❑ MULTI-FAMILY-#OF UNITS: ❑ COMMERCIAL ELECT-/' AL APP ICATION INFORMATION & DESCRIPTION OF WORK CONTRACT PRICE OF WORK: '• 5) 60 ASSOCIATED BUILDING PERMIT#(if applicable): Sko twl�� '� �.; �]wjw ws DESCRIBE SCOPE OF WO', : f)64-121,4 N eCT OL-40 Anil() NN A !-. r°LAG 01-t=Nr /tilr.tto NW./ \INAVC(.03 OCA THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? El NO EKES-Select Scope: El Service El Feeder Circuits-#: Z ❑Complete Re-wire LOW VOLTAGE WORK? ❑NO El YES-#of Devices: SELECT SCOPE(REQUIRED): ❑ Data El Intercom El 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. ❑Other(List All): CODE COMPLIANCE IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: El NO RYES—See Below&Pg.2 VI 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: ONO EYES-See Below&Pg.3 fI Pursuant to RCW 19.28.261,property owners and leaseholders cannot perform electrical work on buildings for rent,sale,or lease I 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: 5tloHp,t4•45►4 TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET moa 7 041& /{Va- cITY I,v(/Zit T STATE 11,1)— ZIP lb" I OWNER PHONE: "`25- 3 $$- 3 3 w S OWNER EMAIL: CONTRACTOR NAME: on uL_ 1.LEG(otic_ CONTRACTOR ADDRESS: STREET ifO AlLV iNA4-41L.L NITL CITY I...v6 AL Tr STATE 110"A. ZIP / 6 Op P( CONTRACTOR PHONE: 112-C -act-I-700 CONTRACTOR EMAIL: els I y e-vG'h..s QZ a/.i il.I e 7 Y C• Gam CONTRACTOR LIC.#(REQUIRED): 041/1-EE 1 1 IL at) CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 037- 6Z PRIMARY CONTACT: DOWNER 1?-CONTRACTOR ['OTHER(Please Specify) CONTACT n CONTACT PHONE: " • it ?&Me/kiS CONTACT EMAIL: 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 Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only PERMIT#: 6- 13- tat E t9o(4, Vo5 Owner/Authorized Agent Signature Date (Revised 1/11/2019) Page 1-Application