9001 AIRPORT RD 2020-08-27 - Laserfiche WebLink

O Lc ELECTRICAL PERMIT APPLICATION EVERETT CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 WASHINGTON (P)425-257-8810 l FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits W PROJECT..SITE>INFORMA.TION PROJECT ADDRESS: 9001 Airport Road AREA: PROJECT TYPE: DINEW CONSTRUCTION ElADDITION EI TENANT IMPROVM NTILD❑REMODEL sg ft BUILDING USE: ❑SFR ❑TOWNHOUSE El DUPLEX C]ADU El MULTI-FAMILY-#OF UNITS: - ELECTRICAL APPLI 'ATION INFORMATION & DESCRIPTION OF WORK , COMMERCIAL CONTRACT PRICE OF WpRI(;$ � ON ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: THIS INSTALLATION INCLUDES THE FOLLQ-NG SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ❑NO .YES-Select Scope:❑ Service ❑Feeder ❑Circuits-#: LOW VOLTAGE WORK? 117 Complete Re wire El NO ❑YES-#of Devices: SELECT SCOPE(REQUIRED): El Data El Intercom ❑Thermostat ❑Audio ❑Secure Access CI Security System 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, ❑Other(List All): ODE IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH�ND OR P R�SONA�ACIAR E qCl IES: El By checking this box, I am stating that I have read and understand all of WAC 296-46B-900, 1- NO III YES--See Below&Pg.2 lected the s ecific re � 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. p as on page 2 ARE YOU AN OWNER PERFORMING WORK AS THE CONTRACTOR WITHOUT ELECTRICAL LICENSURE: Pursuant to RCW 19.28.261,property owners and leaseholders cannot perform electrical work on /Ings 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 ■YES-See Below&Pg.3 See Page 3 signed the AFFIDAVIT on page 3 of this application to receive an exemption from this licensing/certification requirement. . - ' • , S CONTACTS INFORMATION. ; ;',;,• OWNER NAME: . TENANT BUSINESS NAME If Commercial): OWNER MAILING ADDRESS: STREET OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: Bonner Electrical Contracting CONTRACTOR ADDRESS: STREET 1419 Dike Road crry Mount Vernon CONTRACTOR PHONE:3608408710 STATE WA ZIP 98273 CONTRACTOR LIC.#(REQUIRED):SONNEEC904L9 CONTRACTOR EMAIL:brad@bonnerec.com ((' PRIMARY CONTACT: ❑pWNER CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 57801 ❑✓CONTRACTOR ['OTHER(Please Specify) CONTACT NAME: Bili Bonner CONTACT PHONE:3608408710 CONTACT EMAIL:brad@bonnerec.com AGREEMENT 1 hereby certify that 1 have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governingthis 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 rt..' (Wing constru -n or the performance of construction. That f am authorized by the owner of this property to perform the work for which application is made l comply w/l the State C. ;;,,Law 18:27 RCW and 296.200 WAC: City of Everett Official Use Ont / A_ PERMIT#: , _ _ii 3S- 2 E200 0 A/Authori 4-ii •gent Signature ( � 03(p ate (Revised 1/11/2019) Page 1-Application