3200 35TH AVE NE 2020-02-24 - Laserfiche WebLink

!ECTRICAL PERMIT APPLIATION EVERETT 32CITY OF EVERETT PERMIT SERVICES 00 CEDAR STREET,EVERETT,WA 98201 WASHINGTON (P)425.257-8810 I FAX 425-257-8857 1(E)everetteps(g3everettwa,gov I www.everettwa gov/perrnits PROJECT SITE INFORMATION PROJECT ADDRESS: 3200 35th Ave NE BUILDING AREA:NWA sq it PROJECT TYPE: 0 NEW CONSTRUCTION Ei ADDITION ❑TENANT IMPROVMENT ❑REMODEL BUILDING USE: ❑SFR ❑TOWNHOUSE ❑DUPLEX ❑ADU ❑MULTI-FAMILY-#OF UNITS: i COMMERCIAL ELECTRICAL APPLICA,TION NFO ATIOti1DESCRIPTION1OF Non.[a. CONTRACT PRICE OF WORK:$ 5,600.00 (ASSOCIATED BUILDING PERMIT#(if applicable): N/A DESCRIBE SCOPE OF WORK: Install 60A,480v circuit breaker in existing panel for a new piece of customer provided equipment. Provide and install new 60A, 600v rated fused disconnect. Make final connections THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE:(SELECT ALL THAT APP LINE VOLTAGE WORK? NO ❑YES-Select Scope:❑ Service 0 Feeder RICircuits-#:1 0 Complete Re-wire LOW VOLTAGE WORK? NO ❑YES-#of Devices: SELECT SCOPE(REQUIRED): ❑Data ❑Intercom ❑Thermostat 0 Audio 0 Secure Access El 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 Ail): :..att _ CODE COMPLIANCE � � x ea�, IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILmES: NO ❑YES—See Below&Pg.2 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 of this application(see next page),AND Plan Review Is NOT required because I meet all of the following sub sections that do not Sea Page 2 require Plan Review, E YOU AN OWNER PERFORMING WORK AS THE CONTRACTOR WITHOUT ELECTRICAL LICENSURE:tNO InYES-See Below&Pg.3 Pursuant to RCW 19,28261,property owners and Leaseholders cannot perform electrical work on buildings for rent,sale,or tease 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 It RMIATIOH ' \ C OWNER NAME: BMC TENANT BUSINESS NAME(If Commercial?:BMG .. OWNER MAILING ADDRESS: sTREET 3200 35th Ave NE cmEvereft STATE WA a,98201 OWNER PHONE:(253)355-1475 OWNER EMAIL:tom.johnston@buildwithbmc.com CONTRACTOR NAME: Seahurst Electric Inc CONTRACTOR ADDRESS: STRET2915 Chestnut St. coy Everett STATE WA zp 98201 CONTRACTOR PHONE:(425)258-5143 CONTRACTOR EMAIL:dleblanc@seahurst.com CONTRACTOR LIC.#(REQUIRED):SEAHUEIO99QN CITY OF EVERETT BUSINESS UC.#(REQUIRED):18763 PRIMARY CONTACT: ❑OWNER FACONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:(425)258-5143 Dave LeBlanc CONTACTEMAIL:dleblanc@seahurst.com AGREEMENT I hereby certify that t have reed and examined this application and know the same to be true and correct Alt provisions of taws and ordinances governing this type of work wtft 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 slate or local taw regulating construction or the performance erconstruction, That lam authorized by the owner of this p,nperty to perform the work for witch application is made and comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only PERMIT#: 'AAA Nref# E Owner/Auth• ..•Agent Signature Date (Revised 1/11/2019) Page 1-Application