4618 31ST AVE SE 2020-07-13 - Laserfiche WebLink

am. Lai ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES EVERETT 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 FAX 425-257-8857 I(E)everetteus@everetwa gov I www everettwa goy/permits OR04410V,() HOVOIRMATION PROJECT ADDRESS: 4618 31st Ave SE BUILDING AREA: sq ft PROJECT TYPE: 121 NEW CONSTRUCTION 0 ADDITION 0 TENANT IMPROVMENT 0 REMODEL BUILDING USE: Cl SFR El TOWNHOUSE El DUPLEX E ADU 1:1 MULTI-FAMILY-#OF UNITS n COMMERCIAL PLICATION INFORMATION&DESCRIPTION OF WORK CONTRACT PRICE OF WORK:$ 200 'ASSOCIATED BUILDING PERMIT#(if applicable). DESCRIBE SCOPE OF WORK: 100 amp temp power lot 325 THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? LI NO 0 YES-Select Scope: 0 Service 0 Feeder 17 Circuits-#: 0 Complete Re-wire LOW VOLTAGE WORK? 0 NO El YES-#of Devices: SELECT SCOPE(REQUIRED): 1:1 Data ID Intercom 0 Thermostat 0 Audio 0 Secure Access 0 Security System 0 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). iii[ 'i!-MAINArigigagtarifaitirk:276 DE ,sgoqi,-gamtwaysz::AirFN4mp11111 IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: 0 NO 111 YES—See Below&Pg,2 By checking this box,I am stating that I have read and understand all of WAC 296-488-900,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: 571NO OYES-See Below&Pg.3 r---1 Pursuant to RCW 1928,261,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 ort 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: STREET 11624 SE 5th S Ste 100 , Bellevue suit WA 98005 OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: Garner Electric WA LLC CONTRACTOR ADDRESS: arREET402 Valley Ave NW Ste 106 WY Puyallup STATE WA ZIP 98371 CONTRACTOR PHONE:253472-6051 CONTRACTOR EMAIL:agentele@gweusacom CONTRACTOR LIC.#(REOU1RED):GARNEEW864KB CITY OF EVERETT BUSINESS LIG,#(REQUIRED): 052909 PRIMARY CONTACT: DOWNER ZCONTRACTOR OTHER(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. AO provisions of laws and ordinances governing this type of work wilt be completed whether spec/Red 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 properly to perform the worn for which application is made and I comply with the State Contractors Law 18.27 RCW and 296200 WAC, City of Everett Official Use Only PERMIT#: (17-1,;17 / /19 kGkooS(10 .er/Authorized Agent ignature te (Revised 1/11/2019) Page 1-Application