619 33RD ST 2020-02-24 - Laserfiche WebLink

ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES -r 1: 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 [ FAX 425-257-8857 (E)everetteps@everettwa gov I www everettwa.govipermits sq ft PROJECT ADDRESS: 619 33RD ST BUILDING AREA: `��:� PROJECT TYPE: D NEW CONSTRUCTION D ADDITION D TENANT IMPROVMENT 0 REMODEL BUILDING USE: D✓ SFR ❑TOWNHOUSE ❑DUPLEX 0 ADU D MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL CONTRACT PRICE OF WORK:$ 2671.74 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: NEW 100AMP SUBPANEL IN GARAGE, 30 AMP 240 VOLT WELDING CIRCUIT THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE:(SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ❑NO ©YES-Select Scope:0 Service ❑Feeder 0 Circuits-#:,2 0 Complete Re-wire LOW VOLTAGE WORK? El NO 0 YES-#of Devices: SELECT SCOPE(REQUIRED): 0 Data 0 intercom 0 Thermostat 0 Audio D Secure Access 0 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, y'TYy $•. COther(List All): V ,,A,„ : 1 is1107 W4-r'CQD ,M0 : LINP w2h's _ b ry fr IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: [�/ NO In YES—See Below&Pg.2 71 By checking this box, I am stating that I have read and understand all of WAC 296468.900,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:©NO DYES-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. OWNER NAME: NATHAN MUNTZ TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET 619 33RD ST 0,, EVERETT STATE WA zip 98201 OWNER PHONE:425-280-4733 OWNER EMAIL:NAMUNTZc 1OL.CtDM CONTRACTOR NAME: GS HEATING, COOLING&ELECTRICAL LLC CONTRACTOR ADDRESS: mem-3409 EVERETT AVE city EVERETT STATE WA gip 98201 CONTRACTOR PHONE:425-610-4257 CONTRACTOR EMAIL:SARAa@GSHEATING.COM CONTRACTOR LIC.#(REQUIRED):GSHEAHC8218R CITY OF EVERETT BUSINESS LIC.#(REQUIRED):60058 PRIMARY CONTACT: DOWNER I CONTRACTOR [OTHER(Please Specify) CONTACT NAME: SARA LAN CONTACT PHONE:425-610-4257 u' HOLLAI V D 'CONTACT EMAIL:SARA©GSHEATING.COM AGREEMENT:I hereby certify that I have read and examined this application and know the same to be true end 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/am authorized by the owner of this property to perform the work for which application is made and t comply with the State Contractors Lew 18.27 RCW and 296.200 WAC. City of Everett Official Use Only PERMIT#: , � ;'' z � - E \� 1016 �..�. .r.�`� �� it >�� Ouvner/Authorized Ageiit SignaVire Date (Revised 1/11/2019) Page 1-Application