3510 WETMORE AVE 3 2020-04-03 - Laserfiche WebLink

06/05/2019 09: 14II #4253 P. 001/001 1» ELECTRICAL PERMIT APPLI5ATION r:C E V E R E T T CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 wnaMiN4rok (P)425-257-8810 1 FAX 425-257-8857 I(E)everedepe@everettwa.gov I www.everettwa.gov/permits : • . .- •••• PROJLCT*ITE INFORMATION. PROJECT ADDRESS: 3510 WETMORE AVE#3 BUILDING AREA: ., sq ft PROJECT TYPE: 0 NEW CONSTRUCTION ❑ADDITION Q TENANT IMPROVMENT- ❑REMODEL • BUILDING USE: 0 SFR ❑TOWNHOUSE Q DUPLEX 0 ADU 1 ,MULTI-FAMILY-#OF UNITS: 17 COMMERCIAL ELECTRICAL,APPLICATION:INFORM.. ION &.DESCRIPTION OF.WORT( CONTRACT PRICE OF WORK:$ 5000 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: REPLACE PANEL, PARTIAL REWIRE. DAMAGED BY FIRE. ADD SMOKE DETECTORS., NEW RANGE CIRCUIT THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE:(SELECT ALL THAT APPLY) UNE VOLTAGE WORK? L NO Q YES-Select Scope:a Service Q Feeder 0 Circuits-#:5 ❑Complete Re-wire LOW VOLTAGE WORK? 21 NO 0 YES-#of Devices: SELECT SCOPE(REQUIRED): 0 Data ❑ Intercom 0 Thermostat El 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. I_.!Other(List All): ;., :•.. :,:•:fir' . • • ..: ODI::•CO RI.IANCE•::.• •. IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: LX.I NO 0 YES--See Below&Pg.2 t._ni._I By checking this box,I am stating that I have read and understand all of WAC 29846D-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: El NO [LYES-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 pmper 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•I PO- T »:..:,:::: . .. • OWNER NAME:GARY H EI LMAN TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: sTREsT 12406 40TH AVE SE . cm. EVERETT STATE WA zip 98208 OWNER PHONE:425.337.0239 OWNER EMAIL: CONTRACTOR NAME: EYLANDER SALES&SERVICE • • CONTRACTOR ADDRESS: sTREEr3601 EVERETT AVE • ' Gay EVERETT STATE WA zip 98201 CONTRACTOR PHONE:425.259.2161 CONTRACTOR EMAIL: CONTRACTOR LIC,#(REQUIRED)_EYLANSSI42LP 1CITY OF EVERETT BUSINESS LIC.*REQUIRED):016363 PRIMARY CONTACT: []OWNER ©CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME:CENTRA JC CONTACT.PHONE:425.231.2275 • CONTACT EMAIL: 'AGREEMENT:I hereby certify that!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 Spet ified 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 constoic:ion. That I am autholyzed by the owner of this property to perform the work for which application is made and 1 comply with the State Contractors Law 1$27 RCW and 296.200 WAC, City of Everett Official Use Only 4PERMIT# i /(7/7/1 E ��t O Co - I CA Owne• •u n. • .Agent Signature (Revised 1/11/2019) Page 1-Application