211 95TH PL SE 2020-02-25 - Laserfiche WebLink

liz ELECTRICAL PERMIT APPLICATION EVERETT CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 WASHINGTON (P)425-257-8810 I FAX 425-257-8857 l(E)everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 211 95th PL SE BUILDING AREA: sq ft PROJECT TYPE: ❑ NEW CONSTRUCTION El ADDITION ❑TENANT IMPROVMENT ❑ REMODEL BUILDING USE: C✓J SFR ❑TOWNHOUSE ❑ DUPLEX El ADU LI MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL ELECTRICAL APPLICATION INFORMATION & DESCRIPTION OF WORK CONTRACT PRICE OF WORK:$ 807.00 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: 20AMP/240V CIRCUIT FOR A MINI SPLIT AND 20A/120V CIRCUIT FOR GFCI THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ❑ NO ❑✓ YES-Select Scope: ❑Service ❑ Feeder ❑Circuits-#:2 ❑ Complete Re-wire LOW VOLTAGE WORK? ❑✓ NO ❑ YES-#of Devices: SELECT SCOPE(REQUIRED): ❑Data ❑ Intercom ❑Thermostat ❑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: ❑ 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 EYES-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: Jim Benedetto TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET 211 95th PL SE rny Everett STATE WA zw 98208 OWNER PHONE:425-422-0983 OWNER EMAIL:N/A . CONTRACTOR NAME: AS You Wish Electric CONTRACTOR ADDRESS: STREET 825 S Stacy St CITY Seattle STATE wa z,, 98134 CONTRACTOR PHONE:206-783-2525 CONTRACTOR EMAIL:brendak@asyouwishelectric.com Li(b41(01 CONTRACTOR LIC.#(REQUIRED): `s— .�; si '(t:.z.c1",„-, CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 048862 �fl PRIMARY CONTACT: ❑OWNER ✓❑CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:206-783-2525 Brenda Keller CONTACT EMAIL:Brendak@asyouwishelectric.cam AGREEMENT:I hereby certify that 1 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 riot 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 l am authorized by the owner of this property to perform the work for which application is made and t comply with the Stale Contractors Law 18.27 RCW and 296.200 WAG City of Everett Official Use Only PERMIT#: Brenda Keller r 2 --- 07/1912018 E ICI 01— I uC 0 Owner/Authorize t Signature Date (Revised 1/11/2019) Page 1-Application