2020 LAKE HEIGHTS DR WATERFORD PLACE APTS 2021-12-14

SIM 1.111 •ECTRICAL PERMIT APPL 4TION EVERETT CITY OF EVERETT PERMIT SERVICea 3200 CEDAR STREET,EVERETT,WA 98201 WASHINGTON (P)425-257-8810 I FAX 425-257-8857 I (E)everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 2020 Lake Heights Dr. BUILDING AREA: N/A 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: $ 1625.00 ASSOCIATED BUILDING PERMIT#(if applicable): N/A DESCRIBE SCOPE OF WORK: Demo 50A disconnect for trash compactor. Install conduit, wire, and new disconnect for a new 100A trash compactor circuit. L40(yAv-41 layiuy) THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ❑ NO ✓❑ YES-Select Scope: ❑ Service ❑ Feeder ❑ Circuits-#:1 ❑ Complete Re-wire LOW VOLTAGE WORK? Q NO ❑ YES-#of Devices: SELECT SCOPE(REQUIRED): ❑ Data ❑ Intercom ❑ Thermostat ❑ Audio ❑ 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: 0 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: ENO 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: Waterford Apartments TENANT BUSINESS NAME(If Commercial): Same OWNER MAILING ADDRESS: STREET 2020 Lake Heights Dr. c„ Everett STATE WA ZIP 98208 OWNER PHONE:(425) 337-9270 OWNER EMAIL:Waterford@sagemgt.com CONTRACTOR NAME: Seahurst Electric, Inc. CONTRACTOR ADDRESS: sTREET2915 Chestnut St. CITY Everett STATE WA ZIP 98201 CONTRACTOR PHONE:(425) 258-1882 CONTRACTOR EMAIL:dleblanc@seahurst.com CONTRACTOR LIC.#(REQUIRED):SEAHUE1099QN CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 18763 PRIMARY CONTACT: ]OWNER L✓ CONTRACTOR ]OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:(425) 258-5143 Dave LeBlanc CONTACT EMAIL:dleblanc@seahurst.cam 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#: David J.LeBlanc A °�"� �.w 9-16-19 E I- l -&012. Owner/Authorized Agent Signature Date (Revised 1/11/2019) Page 1-Application