4611 RIVERFRONT BLVD 2020-10-22 - Laserfiche WebLink

NM `„ ELECTRICAL PERMIT APPLICATION EVERETT CITY OF EVERt i I PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 WASH IGTON (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov 1 www.everettwa.gov/permits ,[ ... A Z eV. ¢a, Y:;'"Z73"'t'3:5L:LIZailTa l:':. ass"°.,a PROJECT ADDRESS: 4611 Riverfront Blvd BUILDING AREA: sq ft PROJECT TYPE: 0 NEW CONSTRUCTION ❑ADDITION 0 TENANT IMPROVMENT El REMODEL BUILDING USE: IZI SFR O TOWNHOUSE El DUPLEX E3 ADU El MULTI-FAMILY-#OF UNITS: O COMMERCIAL IREM,A € .... ter. 1: _ _ a`- m--t .v,P dt ?' lL * 5�� aitib CONTRACT PRICE OF WORK;$ 250 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: 100 amp temp power lot 306 THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ❑NO El YES-Select Scope:El Service El Feeder El Circuits-#: El Complete Re-wire LOW VOLTAGE WORK? El NO ❑YES-#of Devices: SELECT SCOPE(REQUIRED). El Data ❑ Intercom O Thermostat El Audio El Secure Access O 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. El Other(List All): '., _fir' aagararlf [. ` R :< ::_,..... nfi `Mt.. Zai IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: 12 NO II 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: ZNO OYES-See Below&Pg.3 Pursuant to ROW 19.28261,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 licensinglcertification requirement. x�a_ �4 ty '.'i6 fid'. �:� RH OWNER NAME: Polygon Homes TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: SWEET 11624 SE 5th St Ste 100 c,, Bellevue STATE WA :•, 98005 OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: Garner Electric WA LLC CONTRACTOR ADDRESS: SWEET 402 Valley Ave NW Ste 106 C'TY Puyallup STATE WA ZIP 98371 CONTRACTOR PHONE:253-872 6051 CONTRACTOR EMAIL:agentele t@gweusa.Com CONTRACTOR LIC.#(REQUIRED):GARNEEW864KB CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 052909 PRIMARY CONTACT: ©OWNER 71CONTRACTOR (OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:253-278-7064 Paul Van}`o CONTACT EMAIL:pvantol gweusa.corn AGREEMENT l hereby certify that l 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 t 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#: f i8/30/2019 E )9bq V a OwnerfAuthorized Agent eature Date (Revised 1l11I2019) Page 1-Application