528 TAMARACK AVE 2020-04-02 - Laserfiche WebLink

OPELECTRICAL PERMIT APPLICATION �� CITY OF EVERE t 1 PERMIT SERVICES Nig 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 1 FAX 4857TI(E)everetteps@everettwa.gov I www.everettwa.govipermits .. �f"425-257-8 C.f 41.7WINFORMAT PROJECT ADDRESS: 528 Tamarack Dr BUILDING AREA:1300 sq ft PROJECT TYPE: 0 NEW CONSTRUCTION El ADDITION ❑TENANT IMPROVMENT SLI REMODEL BUILDING USE: ®SFR 0 TOWNHOUSE 0 DUPLEX ❑ADU 0 MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL IN i... p ..° ,IELECTRICAL APPLICATION INFORMATION,8r DESCRIPTIONXOF WORK CONTRACT PRICE OF WORK:$ 2000 ASSOCIATED BUILDING PERMIT#(it applicable): DESCRIBE SCOPE OF WORK: Kitchen remodel. Microwave, disposal, DW circuits THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE:(SELECT ALL THAT APPLY) LINE VOLTAGE WORK? 0 NO ®YES-Select Scope:0 Service ❑ Feeder 0 Circuits-##:8 _ 0 Complete Re-wire LOW VOLTAGE WORK? ®NO 0 YES-#of Devices: SELECT SCOPE(REQUIRED): 0 Data 0 Intercom 0 Thermostat 0 Audio El Secure Access 0 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 device location and installation approval. ❑Other(List All): .48, .. E ',°. COMP IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: gl NO ❑YES—See Below&Pg.2 By checking this box,I am stating that I have read and understand all of WAG 296-46B-900,selected the specific reason on page 2 r 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. if��II OYES YOU AN OWNER PERFORMING WORK AS THE CONTRACTOR WITHOUT ELECTRICAL LICENSURE:OO NO YES-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:Karl Paull TENANT BUSINESS NAME(If Commercial): • OWNER MAILING ADDRESS: STREET 528 Tamarack Dr cm( Everett STATE WA A ftp OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: Pure Power CONTRACTOR ADDRESS: STRE_ET16319 123rd PINE CITY Bothell STATE WA zlv 98011 CONTRACTOR PHONE:206-948-8585 CONTRACTOR EMAIL:karlirl@purepowerwa.com CONTRACTOR LIC.#(REQUIRED):PUREPPL.898MJ CITY OF EVERETT BUSINESS LIC.#(REQUIRED):5?865 PRIMARY CONTACT: ❑OWNER 121CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:2O6-948-8585 Karlin Kersavage CONTACT EMAIL:karlin@purepowerwa.com AGREEMENT:1 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 lam authorized by the owner of this property to perform the work for which application is made and t comply with the State Contractors Law 18.27 RCW and 296.200 WAG. City of Everett Official Use Only PERMIT#: -. 4---- 1// \(i b ' I '1 0 er/Authorized Agent Signature Date (Revised 1/11/2019) Page 1-Application