4618 RIVERFRONT BLVD 2020-10-22 - Laserfiche WebLink

E EtCTRICAL PERMIT APPLICA1 ION CITY OF EVERETT PERMIT SERVICES EVERETT 32C0 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 i(E)everetteps@everettwa gov iwkw everettwagovipermits WASi-UNGTON ta.'A PROJECT ADDRESS: 4618 Riverfront Blvd BUILDING AREA: sq ft PROJECT TYPE: Li NEW CONSTRUCTION LI ADDITION El TENANT INIPROVMENT El REMODEL 1,71 BUILDING USE: LTA SFR El TOWNHOUSE El DUPLEX LI ADU MULT1-FAMILY-#OF UNITS' El COMMERCIAL 0 ., 4.40,011 CONTRACT PRICE OF WORK:$ 250 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: 100 amp temp power lot 372 THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? E NO 7, YES-Select Scope, Li Service El Feeder El Circuits-#: Li Complete Re-wire LOW VOLTAGE WORK? El NO E YES-#of Devices. SELECT SCOPE(REQUIRED): CI Data El Intercom E Thermostat Li Audio El Secure Access E Security System EI 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. C Other(List All). IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: 11,:j NO j 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: ZINO EYES-See Below&Pg. 3 I Pursuant to RCW 19.26.261,property owners and leaseholders cannot perform electrical work on buildings for rent,sale, or lease I 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 licensingicertification requirement - -77740mmTA4or OWNER NAME: Polygon Homes TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: sTREE, 11624 SE 5th St Ste 100 Bellevue s,,, WA 98005 OWNER PHONE: OWNER EMAIL: , , CONTRACTOR NAME: Garner Electric WA LLC CONTRACTOR ADDRESS: srR„T 402 Valley Ave NW Ste 106 cAry Puyallup STATI WA Zip 98371 CONTRACTOR PHONE:253-872-6051 CONTRACTOR EMAIL:agentele@gweusa.com CONTRACTOR LIC.#(REQUIRED):GARNEEW864KB CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 052909 PRIMARY CONTACT: ri Mt/NPR 171CONTRACTOR DOTHER(Please Specify) CONTACT NAME: CONTACT PHONE:253-278-7064 Paul Vanto I CONTACT EMAIL:pvantol@gweusa.com AGREEMENT I hereby certify that I have read and examined this application and know the same to be true and correct Ail provisions of laws and ordinances governing this type of work will be completed whether specified herein or not The gianting 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 poverty to perform the work for which application is made and I comply with the State Contractors Law 18 27 RCW and 295.200 WAG City of Everett Official Use Only PERMIT#: /11/ \tot- cob .8130/2019 E Owner/Authorized Agent S nature Date (Revised 1/11/2019) Page 1-Application