4614 31ST AVE SE 2020-07-13 - Laserfiche WebLink

OMNI ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES EVERETT 3200 CEDAR STREET.EVERETT,WA 98201 WASHTON (P)425-257-8810 I FAX 425-257-8857 1(E)everettepsaeverettwagov 1 www.everettwagov/permits ING aiRi:;;ItW,,, nratlaiatC04614: ECT WEitare PROJECT ADDRESS: 4614 31st Ave SE BUILDING AREA: sq ft PROJECT TYPE: 0 NEW CONSTRUCTION El ADDITION El TENANT IMPROVMENT 0 REMODEL BUILDING USE: El SFR El TOWNHOUSE El DUPLEX El ADU El MULTI-FAMILY #OF UNITS: E1 COMMERCIAL R,VSAYititieige,! " 1ON1PWORMAUON. "DROMPTIO/4 OF CONTRACT PRICE OF WORK:$ 200 ASSOCIATED BUILDING PERMIT#((f applicable): DESCRIBE SCOPE OF WORK: 100 amp temp power lot 327 THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE:(SELECT ALL THAT APPLY) LINE VOLTAGE WORK? El NO D YES-Select Scope:0 Service El Feeder El Circuits-#: ED Complete Re-wire LOW VOLTAGE WORK? 0 NO 0 YES-#of Devices: SELECT SCOPE(REQUIRED): El Data El Intercom El Thermostat El Audio El 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. El Other(List All): 44,t,MtX,WN "..'1$3•417Xitt,** IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: ri 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: [ZINO DYES-See Below&Pg.3 — Pursuant to ROW 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. 0,-,731.44.h:,..„:31:t1A;Z::Satar:FIWRilf*';17,Tiit;;;:.! " •1! OWNER NAME: Polygon Homes TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET 11624 SE 5th S Ste 100 ory Bellevue STATE WA zip 98005 OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: Garner Electric WA LLC CONTRACTOR ADDRESS: STREET 402 Valley Ave NW Ste 106 CITY Puyallup STATE WA 98371 CONTRACTOR PHONE:253-872-6051 CONTRACTOR EMAIL:agentele@gweusa.com CONTRACTOR LIC.#(REQUIRED):GARNEEW864KB CITY OF EVERETT BUSINESS LIC.#(REOUIRED): 052909 PRIMARY CONTACT: DOWNER E1CONTRACTOR DOTHER(Please Specify) CONTACT NAME: CONTACT PHONE:253-278-7064 Paul Vantol 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, Ai/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 I am authorized by the owner of this property to perform the won(for which application is made and t comply with the State Contractors Law/8,27 RCW and 296.200 WAC City of Everett Official Use Only PERMIT* • .E.77 71/1* -O Owner/Authorized Agent Si ature' C'efkte RO% (Revised 1,11/2019) Page 1-Application