3315 SEAWAY BLVD 2020-06-05 - Laserfiche WebLink

EEECTRICAL PERMIT APPLiust 1ION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps@everettwa.gov I www.everettwa.gov/permits 4rEir PROJECT ADDRESS: 3315 Sea Way Blvd A BUILDING AREA: sq ft PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ADDITION NANT IMPROVMENT 0 REMODEL BUILDING USE: ❑SFR Cl TOWNHOUSE El DUPLEX ❑ADU ❑ MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL ''',,::::;,:, ,.:i.,:. -,' ELE ._ C; :10,0kTIQN, N O. , V01*& C rri. I OF W . � CONTRACT PRICE OF WORK:$ 11,200 ASSOCIATED BUILD NG PERMIT#(if applicable): r DESCRIBE SCOPE OF WORK: 1� c A' _- CDcdt — l �?Arn(� V(kilie ( ) 10 T-STAS AND INTERCONNECTIONS - OUR DOOR UNITE 1 PANEL HVAtCONTROL THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? s/2 NO ❑YES-Select Scope: ❑ Service ❑ Feeder ❑Circuits-#: ❑ Complete Re-wire LOW VOLTAGE WORK? ❑ NO ❑✓ YES-#of Devices: 10 SELECT SCOPE(REQUIRED): ❑ Data ❑ Intercom 0 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): •COD OMP+I; Cl ` IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: ✓❑ NO in 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 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. ;A . .,n r "T' 0 i $MAIttia \A nog OWNER NAME: TENANT BUSINESS NAME(If Commercial):Terra Power OWNER MAILING ADDRESS: STREET 3315 Sea Way Blvd Building A C1TY Everett STATE wa Z,P 98203 OWNER PHONE: TOWNER EMAIL: ,,.. t .a ... CONTRACTOR NAME: Datskiy Electric CONTRACTOR ADDRESS: sTREET1908 Island View PL ,,,,-----, c, Anacortes STATE WA /- •X221 CONTRACTOR PHONE:360-941-4754 CONTRACTOR EMAIL:liana.b@datskiyelectric.com / 7` � CONTRACTOR LICi , \*),ir--- .#(REQUIRED) DATSKEL820JT CITY OF EVERETT BUSINESS LIC.#(REQUIR D) Applie. // r PRIMARY CONTACT: DOWNER ✓❑CONTRACTOR ❑OTHER(Please Specify) 7/ CONTACT NAME: CONTACT PHONE:360-941-4754 Liana Borishkevich CONTACT EMAIL:liana.b@datskiyelectric.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 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#: 0.,0Ye nt 2. 11 - 1 E ��tOZ - Og 1 Owner/Authorized Ag Sign re Date I (Revised 1/11/2019) Page 1-Application