4603 RIVERFRONT BLVD 2020-07-02 - Laserfiche WebLink

E EtECTRICAL PERMIT APPLICA?ION CITY OF EVERETT PERMIT SERVICES EVERETT 3200 CEDAR STREET,EVERETT,WA 98201 ASHINGTON (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwagov I wweverettwa.gov/permts w :,‘1:04,4*.daftiVOX 114 ALZ ,A4.41.444.1,444.444&46e t4',4,'":0 Alas <:'-nPOW*Var, PROJECT ADDRESS: 4603 Riverfront Blvd BUILDING AREA: sq ft PROJECT TYPE: I-0 NEW CONSTRUCTION El ADDITION 0 TENANT IMPROVMENT D REMODEL BUILDING USE: WI SFR 0 TOWNHOUSE El DUPLEX El ADU El MULTI-FAMILY #OF UNITS: El COMMERCIAL Avigtec CONTRACT PRICE OF WORK:$ 250 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: 100 amp temp power lot 310 THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE:(SELECT ALL THAT APPLY) LINE VOLTAGE WORK? El NO 0 YES-Select Scope:0 Service 0 Feeder I:Circuits-#: El Complete Re-wire LOW VOLTAGE WORK? El NO 1:1 YES-#of Devices: SELECT SCOPE(REQUIRED): 0 Data El Intercom 0 Thermostat 0 Audio CI Secure Access El 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. E Other(List All): IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: Fl NO II YES--See Below&Pg 2 By checking this box, I am stating that I have read and understand all of WAC 29646B-900,selected the specific reason on page 2 of this application(see next page),AND Plan Review is NOT required because I meet ail 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: 7INO DYES-See Below&Pg.3 Pursuant to RCW 19.28161,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,' Abri•• „ • OWNER NAME: Polygon Homes TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: srnesr 11624 SE 5th St Ste 100 cmr Bellevue sTATE WA z p 98005 OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: Garner Electric WA LLC CONTRACTOR ADDRESS: STREET 402 Valley Ave NW Ste 106 cry Puyallup STATE WA Z I P 98371 CONTRACTOR PHONE:253-872-8051 CONTRACTOR EMAIL:agenteie@gweusacum CONTRACTOR LIC,#(REQUIRED):GARNEE1A/88.4KB CITY OF EVERETT BUSINESS LIC.ffiREQUIRED): 052909 PRIMARY CONTACT: DOWNER OCONTRACTOR F 10THER(Please Specify) CONTACT NAME: CONTACT PHONE:253-278-7064 Paul Vantol CONTACT EMAIL:pvantOl@gweusa,com AGREEMENT:I hereby certify that have read and examined this apricot n 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 am authorized by the owner of this property to perform the work for which application is made and! comply with t 'ate Contractors Law 1827 RCW and 296.200 WAC. City of Everett Official Use Only PERMIT#: //(40-'/ 4/-7 , 8/30/2019 EitAii;* Of)/ 0 erlAuthorized Agent fiignature Date (Revised 1/11/2019) Page 1-Application