1016 GRAND AVE 2020-03-06 - Laserfiche WebLink

12/11/2018 10: 16 #3890 P. 001/002 ELECTRICAL IRM' T & FIRE ALARM PMIT APPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 (P)425-257-8810 1 FAX 425-257-8857 1 (E)everettepstieverettwa.gov I www.everettwa.gov/permits P F ? . . ''ar'SITI-I:NFORMATION� :.:... ' .J. �Roa�c. PROJECT ADDRESS:1016 GRAND AVE PROJECT TYPE: ❑NEW CONSTRUCTION 0 ADDITION 0 TENANT IMPROVMENT ❑ REMODEL BUILDING USE: SFR El TOWNHOUSE 0 DUPLEX El ADU ❑MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL BUILDING AREA: sq ft EI;E.CTRIGAL APPLICATION INFORMATION : . . . •: . . CONTRACT PRICE OF WORK:$1000 'ASSOCIATED BUILDING PERMIT#(if applicable): 13 THIS LOW VOLTAGE WORK? ❑ NO ❑YES-#OF DEVICES: IS THIS A FIRE ALARM PERMIT? 0 NO 0 YES-Plans required for review(Both Electrical and Fire Department inspections are required) ..••..... , •,bESCRIPTIONOF�WORKi`A�COOIE COMPLIANCE:. ' • • • .. .. DESCRIPTION OF WORK: REPLACE DOWNSTAIRS BATHROOM HEATER, HALL HEATER,MISC IS THIS PERMIT EDUCATION,INSITUTIONAL.,HEALTH AND/OR PERSONAL CARE FACILITIES: ❑NO 0 YES—See Below&Pg.2 (� By checking this box,I am stating that I have read and understand all of WAC 298.46E-900,selected the specific reason on page 2 �J 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 Pursuant to RCW 19.28.281,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 signed the See Page 3 AFFIDAVIT on page 3 of this application to receive an exemption from this licensing/certification requirement. .:CONTACT:INFORMATION OWNER NAME:LESLIE MINOR TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: sTREET1016 GRAND AVE cm EVERETT STATE WA zip 98201 OWNER PHONE:425,345.7894 .- - ,OWNER EMAIL:, CONTRACTOR NAME:EYLANDER SALES& SERVICE CONTRACTOR ADDRESS: srREET3601 EVERETT AVE crr EVERETT STATE v Y�I1� A Zp 98201 CONTRACTOR PHONE:425.259.2161 CONTRACTOR EMAIL: CONTRACTOR LIC.14REQUIRED):EYI.ANSS142LPCITY OF EVERETT BUSINESS LIC.#(REQUIRED): 016363 PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR O OTHER(Please Specify) CONTACT NAME: OTHER CONTACT PHONE:425.231.2275 CONTACT EMAIL: AGREI=MENT:I hereby certify that!have read and examined this application and know the same to be true and consct. 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 t comply with the State Contractors Law 18.2T RCW and 298.200 WAC. City of Everett Official Use Only ' PERMIT# MQ)1,1-olb Owner/• •thorize•Agent Signature Date (Revised 11/&2018) Page 1-Application