1130 RAINIER AVE B 2020-04-02 - Laserfiche WebLink

07/05/2019 09: 17 1 #4299 P. 001/001 r11111111 111: ECTRICAL PERMIT APPLICATION E V E R E T T . CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 wAENirvaroN (P)425-257-8810 j FAX 4_,......._.._25-257-8857 (E)sverettepsc,everettwa_apvl www.evereuva.gov/permits • PROJECT SITE INFORMATION PROJECT ADDRESS: 1130 RANIER AVE BUILIDNG B 'BUILDING ARE � A ' sq ft PROJECT TYPE: CI NEW CONSTRUCTION ❑ADDITION Q TENANT IMPROVMENT 0 REMODEL BUILDING USE: ❑SFR D TOWNHOUSE 0 DUPLEX ❑ADU 0 MULTI-FAMILY-#OF UNITS: El ELECTRICAL APPLICATION INFORMATION & DESCRIPTION OF WORK COMMERCIAL CONTRACT PRICE OF WORK:$ 2500 (ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: • REPLACE MAIN BREAKER/REQUIRES PUD SHUTDOWN _. • THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE:(SELECT ALL THAT APPLY) LINE VOLTAGE WORK? 0 NO ✓C)" YES-Select Scope;Q✓ Service D Feeder D Circuits-#: D Complete Re-wire LOW VOLTAGE WORK? D NO D YES-#of Devices: SELECT SCOPE(REQUIRED): Q Data D Intercom 0 Thermostat ❑Audio D Secure Access []Security System 0 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 deylce location and installation approval. Q Other(List All): CODE COMPLIANCE. IS THIS P-RMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: E✓ NO i_I YES—See Below&Pg_2 RI By checking this box,I am stating that I have read and understand all of WAC 29646B-900,selected the specific reason on page 2 RI of this application(see next page),ANC 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 DYES-See Below&.Pg.3 EPursuant to ROW 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 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: EVERET HOUSING AUTH TENANT BUSINESS NAME If Commercial : OWNER MAILING ADDRESS: sir PO BOX 1547 • cm EVERETT STATE WA zP 98206 OWNER PHONE:425.258.9222 OWNER EMAJL: CONTRACTOR NAME: EYLANDER SALES & SERVICE —a CONTRACTOR ADDRESS: sireEr3601 EVERETT AVE Cnt EVERETT STATE WA . ZIP 98201 CONTRACTOR PHONE:425.259.2161 CONTRACTOR EMAIL:JCeylafder@yahOO.com CONTRACTOR LIC.#(REQUIRED):EYIANSS142LP • CITY OF EVERETT BUSINESS LIC.#(REQUIRED):016363 PRIMARY CONTACT: DOWNER OCONTRACTOR ©OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:425.231.2275JC CONTACT EMAIL: AGREEMENT:I hereby ,lily ce that t have read arra examined this applicauan ane now the same robe true a carract !provisions of laws and ordinsnoas$event ng 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 regal=ting construction or the performance of construction. That 1 am authorized by the owner of this property to perform the work for which application is made and! comply with;-_ ate Contractors Law 18.27 RCW and 296.200 WAG i City of Everett Official use Only .�` .G// PERMIT#: -, • E 8et 07 -®-5, O,'' r/Authorize =nt Signature Date • (Revised 1/11/2019'J Page 1-Application