4529 RIVERFRONT BLVD 2020-07-02 - Laserfiche WebLink

am La: ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES EVERETT 3200 CEDAR STREET,EVERETT,WA 98201 WA SH I N 0 TO N (P)425-257-8810 I FAX 425-257-8857 I(E)everetteos@everettwa goy I wwweverettwagovfoormits giirifrAW 'T,;,,i2Mifiii41:IFT:7777.17 ,. .AIM PROJECT ADDRESS: 4531 Riverfront Blvd BUILDING AREA: sq ft PROJECT TYPE: [Z]NEW CONSTRUCTION El ADDITION 0 TENANT IMPROVMENT 0 REMODEL BUILDING USE: 0 SFR fl TOWNHOUSE Ti DUPLEX El ADU El MULTI-FAMILY-#OF UNITS: 17 COMMERCIAL CONTRACT PRICE OF WORK:$ 250 ASSOCIATED BUILDING PERMIT#(if applicable). DESCRIBE SCOPE OF WORK: 100 amp temp power lot 312 THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? 0 NO 0 YES-Select Scope: 0 Service 0 Feeder CI Circuits-#: El Complete Re-wire LOW VOLTAGE WORK? 0 NO El YES-#of Devices: SELECT SCOPE(REQUIRED): 0 Data 0 Intercom 0 Thermostat 0 Audio 0 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. E Other(List Ail) 4rVi—il-ri-40-44g-t1k4-k.i."1-wei-,-- ,0,,,,'-:- :-,,,;Com., IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: J NO II 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 UCENSURE: 21140 DYES-See Below&Pg. 3 flPursuant to RCW 1928.261, 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 1:?Tg4,:9q'",;fir4:::AX;4:;niPirl;itrnl:::?:VZ,k'L'.'*::;'''i4 T,iltit4'ni,i, &iiiitX,;;:...Ztt::::t.43.1-71.7::::.&tgittailtICCIP:- ,:,i'''.• OWNER NAME: Polygon Homes TENANT BUSINESS NAME(if Commercial): OWNER MAILING ADDRESS: sTREET 11624 SE 5th St Ste 100 crry Bellevue STATE WA 71,, 98005 OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: Garner Electric WA LLC CONTRACTOR ADDRESS: sTREET 402 Valley Ave NW Ste 106 — ciry Puyallup STATE WA ,,, 98371 — CONTRACTOR PHONE:253-872-6051 CONTRACTOR EMAIL:agentele@gweusa.com CONTRACTOR LIC.#(REQUIRED):GARNEEW864K5 CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 052909 PRIMARY CONTACT: EJOWNER CONTRACTOR I 10THER(Please Specify) . CONTACT NAME: CONTACT PHONE:253-278-7064 Paul Vanto I CONTACT EMAIL:nvantol@gweusa.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 stale 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 Stare Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only / i - ,----i PERMIT# ee,71 8i20/2019 E noic , Own.r/Autherized Agent Signet Date (Revised 1/1112019) Page 1-Application