4601 RIVERFRONT BLVD 2020-07-02 - Laserfiche WebLink

aim ELECTRICAL PERMIT APPLICATION EVERETT OF EVERETT PERMIT SERVICES V 3200 CEDAR STREET. EVERETT.WA 98201 WASH,NorON (P)425-257-88.10 I FAX 425-257-8857 1(E)everettepsgeverettwa.gov i www.everettwagavtperm(ts EC fO (ia „;":- PROJECT .:PROJECT ADDRESS: 4601 Riverfront Blvd BUILDING AREA: sq ft PROJECT TYPE: RI NEW CONSTRUCTION 0 ADDITION 0 TENANT IMPROVMENT El REMODEL BUILDING USE: ®SFR El TOWNHOUSE El DUPLEX El ADU ❑MULTI-FAMILY-#OF UNITS: 71 COMMERCIAL CONTRACT PRICE OF WORK:$ 250 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: 100 amp temp power lot 311 THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE:(SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ❑ NO ❑YES-Select Scope: ❑Service El Feeder 0 Circuits-#: El Complete Re-wire LOW VOLTAGE WORK? ❑ NO 0 YES-#of Devices: SELECT SCOPE(REQUIRED): ❑Data ❑Intercom El Thermostat 0 Audio ❑Secure Access 0 Security System El 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): _ °r ° 71 z,p i000 ), IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: (i NO YES--See Below&Pg.2 By checking this box, I am stating that I have read and understand all of WAC 296-468.900,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: ®NO OYES-See Below&Pg.3 Pursuant to RCVV 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. OWNER NAME: Polygon Homes TENANT BUSINESS NAME(if Commercial): OWNER MAILING ADDRESS: srRssr 11624 SE 5th St Ste 100 GIT., Bellevue STATE WA zp 98005 OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: Gamer Electric WA LLC CONTRACTOR ADDRESS: sTSEET402 Valley Ave NW Ste 106 cam, Puyallup s,ATr WA ,gyp 98371 CONTRACTOR PHONE:253-872-6051 CONTRACTOR EMAIL:agenteie@gweusa.corn CONTRACTOR LIC,#(REQUIRED):GARNEEW864KB CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 052909 PRIMARY CONTACT: ❑OWNER ©CONTRACTOR MOTHER(Please Specify) CONTACT NAME: CONTACT PHONE:253-278-7064 Paul. Vantol CONTACT EMAIL:pvantol r©gweusa.com AGREEMENT:t hereby certify that f have read and examined this application and know the same to be true and correct 411 provisions of laws and ordinances governing tins 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 comply with the State Contractors 18.27 RCW and 296.200 WAC. City of Everett Official Use Only 9 IQ l 3 r tf iI PERMIT E 8P20/2019 l \O� Owner/Authorized Agent Sigg"nature Date {Revised 1!1112019} Page4 Application