1802 75TH ST SW 2020-02-25 - Laserfiche WebLink

E CTRICAL PERMIT APPLI TION / /� CITY OF EVERETT PERMIT SERVICES ��/ I 3200 CEDAR STREET, EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 1 (E)everetteps@everettwa.gov 1 www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 1 802 - 75th Street SW BUILDING AREA: 2ndl floor roof top sq ft PROJECT TYPE: ❑ NEW CONSTRUCTION ] ADDITION ] TENANT IMPROVMENT ❑ REMODEL BUILDING USE: ❑ SFR ❑ TOWNHOUSE ❑ DUPLEX ADU MULTI-FAMILY-#OF UNITS: ❑✓ COMMERCIAL ELECTRICAL APPLICATION INFORMATION & DESCRIPTION OF WORK CONTRACT PRICE OF WORK: $ 17,000 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: Install feeder to new AHU. Previously designated "future" on electrical construction drawings. THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? n NO ] YES-Select Scope: I Service ✓❑ Feeder n Circuits-#: 1 Complete Re-wire LOW VOLTAGE WORK? ] NO n YES-#of Devices: SELECT SCOPE (REQUIRED): ❑ Data ❑ Intercom ❑ Thermostat C Audio ❑ Secure Access n 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: 7 NO ❑ 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. ARE YOU AN OWNER PERFORMING WORK AS THE CONTRACTOR WITHOUT ELECTRICAL LICENSURE: ❑✓ NO ❑YES-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: Snohomish Co PUD No. 1 TENANT BUSINESS NAME(If Commercial): PUD OWNER MAILING ADDRESS: STREET 1802 75th Street SW civ Everett STATE WA Z,, 98203 OWNER PHONE:425-783-8646 OWNER EMAIL:grhespe@snopud.com CONTRACTOR NAME: Valley Electric CONTRACTOR ADDRESS: STREET1100 Merrill Creek Pkwy clTv Everett STATE WA ,,, 98203 CONTRACTOR PHONE:425-308-4393 CONTRACTOR EMAIL:teresaS@VeleCtric.COm CONTRACTOR LIC.#(REQUIRED): CITY OF EVERETT BUSINESS LIC.#(REQUIRED): PRIMARY CONTACT: OWNER ['CONTRACTOR ]OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:425-308-4393 Teresa S CONTACT EMAIL:teresas©velectric.corn AGREEMENT:j. reby 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,/,' 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 res'lati g 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 ,'h th to Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only / PERMIT#: L______ Li /D - f q E ii,t,q- d Own /Autho zed Agent Signature Date (Revised 1/11/2019) Page 1-Application