3315 SEAWAY BLVD 2020-06-05 - Laserfiche WebLink

` ELECTRICAL ?ERG OT APP ,9cc ATION CITY OF EVERETT PERMIT SERVICES <'.'' �� ' +�tF: add' 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 �.. - -- ..__. pkeJ Cd g T FOR AT© '9 - - iPROJECT ADDRESS: 33)3 `,,GALEA 13i.VP.Er✓EcerTG .72'O3 BUILDING AREA: sq ft PROJECT TYPE: NEW CONSTRUCTION 0 ADDITION 0 TENANT IMPROVMENT 0 REMODEL ,-� BUILDING USE: 0 SFR 0 TOWNHOUSE 0 DUPLEX 0 ADU 0 MULTI-FAMILY-#OF UNITS: / COMMERCIAL L , ELECTEIRCAL APPLDCAVOM RNFORMATION & NEScRIPTP1OH OF WORK ------i CONTRACT PRICE OF WORK:$ 70 00o„4s ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: /N�kL- -1 Ai 61 yoic.6- nzm Vim'►' C' `-4 , /6 'E 'f - x i" -r-if- lT'5 ? -rite S cj� f20oM • THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? 0 NO 0/YES-Select Scope: © Service U Feeder 0 Circuits-#: ®Complete Re-wire 0 LOt Y LOW VOLTAGE WORK? NO ES-#of Devices: /410 SELECT SCOPE(REQUIRED) Data i• Intercom 0 Thermostat 0 Audio 0 Secure Access 0 Security System o 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. 0 Other(List All): _____ COOS COMPUe NC '.._ T . _.. 15_THHIS PERMIT EDUCATION, INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: .'NO ii, YES See Below&Pg. i�;; 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 '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. ARE YOU AN OWNER PERFORMING WORK AS THE CONTRACTOR WITHOUT ELECTRICAL LICENSURE: ON/0 ®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. .CONtAC7 INFOR ATIOW OWNER NAME:`-rer--V 'Pt7t��Z TENANT BUSINESS NAME(If Commercial): e ---V-. To — OWNER MAILING ADDRESS: STREET ^ i 58-0 ,e Zhi4 CITY Y(ASTATE tilt • ZIP ( O ov O OWNER PHONE: 1-f2-1,1-f2-1, ^37-11-2-fa OWNER EMAIL - - CONTRACTOR NAME: Com{ Vi 62 0n z-LG 1CONTRACTOR ADDRESS: STREET /M/O /C /2"177711.- s/ .5-4(-5 CIN x-/12-/z- y STATE ZIP 9TO J pp EMAIL: 7��'S) cQ_ WC/7 6F0,7• _ CONTRACTOR PHONE:yZ..5---6/6 ^��Z CONTRACTOR CONTRACTOR LIC.#(REQUIRED):Uwe QOL 852.0 ICITY OF EVERETT BUSINESS LIC.#(REQUIRED): 'Ill s PRIMARY CONTACT: U.)24INER ❑CONTRACTOR ❑OTHER(Please Specify) p a 01( / �f CONTACT NAME: CONTACT PHONE: 1-(2�-- 6 ( D r 755 Z , M L �,1 /G CONTACT EMAIL: CS_ UM e) . A AGREEMENT.:I hereby certify that 1 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 t performance of construction. That!am authorized by the owner of this property to perform the work for which application is made and I comply with the State Contract w 18.27 RCW and 296.200 WAC. City of Everett Official Use Only PERMIT#: b3-Z�,� F '16 3 - 1 cC, _ Ow r/Authorized Agent Signature Date ,� (Revised 1/11/2019) Page 1-Application