3726 GRAND AVE 2020-08-27 - Laserfiche WebLink

CTRICAL PERMIT APPL 1'ION "IP4414"—A-- CIN OF EVERETT PERMIT SERVICE 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT, ITE INFORMATION n PROJECT ADDRESS: 3726 Grand Ave BUILDING AREA: 1188 sq ft PROJECT TYPE: El NEW CONSTRUCTION El ADDITION 0 TENANT IMPROVMENT ✓❑ REMODEL BUILDING USE: ©SFR ❑TOWNHOUSE El DUPLEX ❑ADU ❑MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL ELECTRICAL PPU ATION I FORMA'TI N . ESCRIP'll ION:OF.1MY�3►1F'tlf ... CONTRACT PRICE OF WORK:$ 10000 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: New 200amp service and whole house rewire THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) UNE VOLTAGE WORK? El NO ©YES-Select Scope:0 Service ❑ Feeder ❑Circuits-#: ID Complete Re-wire LOW VOLTAGE WORK? 0 NO El YES-#of Devices: SELECT SCOPE(REQUIRED): ❑Data El Intercom ❑Thermostat ❑Audio El Secure Access ❑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. ❑Other(List All): IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: 0 N d YES—See Below&Pg.2 ❑ By checking this box,I am stating that I have read and understand all of WAC 296-46B-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: ©NO OYES-See Below&Pg.3 ❑ Pursuant to RCW 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. CONTACT INFORMATION OWNER NAME: Bill Velasco TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: sTREEr 13724 57th Ave. crrY Marysville STATE Wa ZIP 98271 OWNER PHONE:425-737-8639 OWNER EMAIL:itbudbilly@yahoo.com CONTRACTOR NAME: Mountlake Electric LLC CONTRACTOR ADDRESS: STREET 5902 221st ST SW CITY Mountlake Terrace STATE Wa ZIP 98043 CONTRACTOR PHONE:425-229-4999 CONTRACTOR EMAIL:mountlake-electric@outlook.com CONTRACTOR LIC.#(REQUIRED):EC MOUNTEL866MS ICITY OF EVERETT BUSINESS LIC.#(REQUIRED):053693 PRIMARY CONTACT: [DOWNER ['CONTRACTOR ['OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:425-229-4999 David Kaufman CONTACT EMAIL:mountlake-electric©outlook.com 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!am authorized by the owner of this property to perform the work for which application is made and comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only PERMIT#: E \611) () 5 Owner/Authorized Agent Signature Date (Revised 1/11/2019) Page 1-Application