1907 100TH ST SW 2020-02-25 - Laserfiche WebLink

E :CTRICAL PERMIT APPLIi ►TION EVERETT CITY OF EVERETT PERMIT SERVICE) 3200 CEDAR STREET. EVERETT.WA 98201 WASHINGTON (P)425-257-8810 FAX 425-257-8857 I(E)everetteps@everettwa.gov www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 1 907 - 100th St. SW Everett BUILDING AREA: sq ft PROJECT TYPE: ❑ NEW CONSTRUCTION El ADDITION El TENANT IMPROVMENT ❑ REMODEL BUILDING USE: ❑✓ SFR 71 TOWNHOUSE ❑ DUPLEX El ADU MULTI-FAMILY-#OF UNITS: ❑ COMMERCIAL ELECTRICAL APPLICATION INFORMATION & DESCRIPTION OF WORK CONTRACT PRICE OF WORK: $ 466.00 ASSOCIATED BUILDING PERMIT# (if applicable): DESCRIBE SCOPE OF WORK: Replaced furnace and reconnected wires. THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ❑✓ NO El YES-Select Scope: ❑ Service ❑ Feeder El Circuits-#: 1 n Complete Re-wire LOW VOLTAGE WORK? El NO ❑✓ YES-#of Devices: 1 SELECT SCOPE (REQUIRED): El Data Intercom ElThermostat ❑ Audio El Secure Access ❑ 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. ❑ 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 u, OWNER NAME: Joyce Nicol TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET 1907 - 100th St. SW CITY Everett STATE WA , 98204 OWNER PHONE: 425-353-0844 OWNER EMAIL: CONTRACTOR NAME: Kalmey Heating CONTRACTOR ADDRESS: STREET 9025 W. Meadow Lake Drive CITY Snohomish STATE WA zip 98290 CONTRACTOR PHONE: 360-568-0162 CONTRACTOR EMAIL: Lisakalmey@aol.com CONTRACTOR LIC.#(REQUIRED): KALMEH*001 CP CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 032304 PRIMARY CONTACT: ✓ OWNER ]CONTRACTOR ['OTHER(Please Specify) CONTACT NAME: Joyce Nicol CONTACT PHONE: 425-353-0844 CONTACT EMAIL: AGREEMENT:I hereby 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 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 I am authorized by the owner of this property to perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only PERMIT#: - ( " :; E Owner/Authorized Agent Signatu a Date (Revised 1/11/2019) Page 1-Application