427 MORGAN RD 2020-03-09 - Laserfiche WebLink

,,:) ,",, mid \ 4.77- ELECTRICAL PERMIT APPLIt.o,-.TION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I wwweverettwaR677Nrrnit , PROJECT SITE INFORMATION PROJECT ADDRESS: 427 Morgan Rd Everett, WA 98203 BUILDING AREA: 2102 sq ft PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ADDITION ❑TENANT IMPROVMENT Q/REMODEL BUILDING USE: ❑✓ SFR ❑TOWNHOUSE ❑ DUPLEX ❑ADU ❑ MULTI-FAMILY-#OF UNITS ❑ COMMERCIAL ELECTRICAL APPLICATION INFORMATION & DESCRIPTION-OF WORK CONTRACT PRICE OF WORK:$ 8000 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: Rewire after fire new servic low voltage and rough in .�a '1_ mob; I 4 cic.1--e r G', r-(, THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ❑ NO ❑✓ YES-Select Scope: ❑✓ Service ❑ Feeder ❑ Circuits-#: ❑ Complete Re-wire LOW VOLTAGE WORK? ❑ NO ❑✓ YES-#of Devices:1 SELECT SCOPE(REQUIRED): El 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: ✓❑ 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: ONO EYES-See Below&Pg. 3 Pursuant to ROW 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: Greenleaf TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET 427 Morgan Rd Everett, WA 98203 CITY STATE ZIP OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: R V B ELECTRIC & CONSTRUCTION INC CONTRACTOR ADDRESS: STREET2803 GRAND AVE CITY Everett STATE WA ZIP 98201 CONTRACTOR PHONE:425-344-9180 CONTRACTOR EMAIL:OFFICE@RVBELECTRIC.COM CONTRACTOR LIC.#(REQUIRED):RVBELVB841M8 CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 55896 PRIMARY CONTACT: DOWNER ❑✓CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:425-344-9180 ROMAN BOYARCHUK CONTACT EMAIL:OFFICE@RVBELECTRIC.COM 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• t 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 Co :c: Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only PERMIT#: r rr _ E \.'kC --- WO Owner/Authorized Agent Signature Date (Revised 1/11/2019) Page 1-Application