509 75TH PL SW 2020-02-25 - Laserfiche WebLink

E LLECTRICAL PERMIT APPLILATION CITY OF EVERETT PERMIT SERVICES EVERETT 3200 CEDAR STREET,EVERETT,WA 98201 ASHINGTON (P)425-257-8810 I FAX 425-257-8857 I(E)everettepsalieverettwa.gov I wom.eve rettwa.goviper m its W • PROJECT SITE INFORMATION PROJECT ADDRESS: 509 75th PI SW Everett WA 98203 BUILDING AREA: sq ft PROJECT TYPE: D NEW CONSTRUCTION Eu ADDITION 0 TENANT IMPROVMENT 0 REMODEL BUILDING USE: [g] SFR EI TOWNHOUSE El DUPLEX 0 ADU El MULTI-FAMILY #OF UNITS: El COMMERCIAL ELIECTRICAL&PPLICATION INFORMATION & DESCRIPTION OF'wornK CONTRACT PRICE OF WORK: $ 3500 !ASSOCIATED BUILDING PERMIT#(If applicable): DESCRIBE SCOPE OF WORK: Adding 2 20 amp 120v circuits.And 1 240v Scamp circuit. (Kitchen remodel) THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? El NO El YES-Select Scope: El Service CI Feeder 7 Circuits-#: 2 El Complete Re-wire LOW VOLTAGE WORK? Iii NO [1 YES-ifof Devices: SELECT SCOPE (REQUIRED): El Data 0 intercom fl Thermostat El Audio El Secure Access El 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. EI Other(List All): CODE COMPLIANCE IS THIS PERMIT EDUCATION, INSTITUTIONAL,HEALTH ANDIOR PERSONAL CARE FACILITIES: NO El YES-- See Below&Pg.2 "--1 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 YOU AN OWNER PERFORMING WORK AS THE CONTRACTOR WITHOUT ELECTRICAL LICENSURE: ONO OYES-See Below&Pg. 3 flPursuant 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 licensingtertification requirement. CONTACT-INFCIRMATIO,Nk ' OWNER NAME: Friward Shattiprap TENANT BUSINESS NAME(If commercial): OWNER MAILING ADDRESS: LTqEET 509 75th DI SW Eve WA z 98203 OWNER PHONE:4253661588 OWNER EMAIL: shattleroeggmail.com CONTRACTOR NAME: Aqualine Plumbing, Electrical and Heating CONTRACTOR ADDRESS: 5TilEET 625 Strander Blvd#A CT? Tukwila ,TATE WA Z'P 98188 CONTRACTOR PHONE:2068768496 ICONTRACTOR EMAIL:Aqua linefa milyggma ilcom CONTRACTOR LIC.#( E01.?1RED): AQUALPF81399icrry OF EVERETT BUSINESS Lig,#(REOUIRED): 59912 PRIMARY CONTACT: ]OWNER DCONTRACTOR DOTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 4253661588 Edward Shattlerae CONTACT EMAIL shattleroeggmall.com AGREEMENT:I hereby cen.ify that/have read and examined this appPcation and know the same to be true and cosrectAft provisions of Saws and outran ces govemmg this ipe a!Avx wit(he compfered whether so ecibed herein or not. The gmnttng of n permit does not piesume to give a uthonly to Mate or cancel the pmvisions of any other sta te or focal tow reguta ring construction or the performance of oonstru coon. That am a uthanzed by the owner of this property to perform die wont for which application is made and comply with rite State Contract=Law 18.27 f?CIN and 2915.200 WAC. City of Everett Off[dal Use Only PERMIT#: 1018/2019 E v3 < o Oweer/Autho zed Agent S tare Date (Revised 10112019,f Page 1-Application