|
HECTRICAL PERMIT APPLIl1JTION
<br /> ��,, CITY OF EVERETT PERMIT SERVICES
<br /> 3200 CEDAR STREET,EVERETT,WA 98201
<br /> (P)425-2574810 I FAX 425-257-8857 I(E)everettepst everettwa.gov J www.everettwa.gov/permits
<br /> s.:e I Y.,"y� a; s / ,i::...,i�Sr�A�y�k4�,�T�£�.?Nz .v:. ,h t£S;5 �£O°t r P �F ! t�K i #t r�z�mdav '4A k - U tg tt
<br /> ,,,.�,.:: �F � , .... �,...�,tr� PRO�EICT�SITE�I;NF�RMATIf�N : , ,.:::, t .�;f���u�kr r,<�.._� ��.;.`, ,��r�����S. •
<br /> PROJECT ADDRESS: 2304 8TH ST BUILDING AREA: 1802 sq ft
<br /> PROJECT TYPE: ❑NEW CONSTRUCTION ❑ADDITION ❑TENANT IMPROVMENT 0 REMODEL
<br /> BUILDING USE: 0 SFR El TOWNHOUSE ❑ DUPLEX ❑ADU ❑MULTI-FAMILY-#QF UNITS: ❑COMMERCIAL
<br /> f! kfln h, oagmg Et gmg-gpc Amw ttma N pxgoEggR1emti ;oroyORfvmuinm.
<br /> CONTRACT PRICE OF WORK:$ 1788.00 ASSOCIATED BUILDING PERMIT#(if applicable):
<br /> DESCRIBE SCOPE OF WORK:
<br /> NEW 50AMP HOT TUB CIRCUIT, ADD OUTDOOR RECEPTACLE
<br /> THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY)
<br /> LINE VOLTAGE WORK? ❑ NO ❑✓ YES-Select Scope: ❑Service ❑Feeder ✓❑Circuits-#:1 ❑Complete Re-wire
<br /> LOW VOLTAGE WORK? ✓❑NO El YES-#of Devices:
<br /> SELECT SCOPE(REQUIRED): El Data ❑ Intercom ❑Thermostat ❑Audio ❑Secure Access ❑Security System
<br /> ❑ Fire Alarm-Installations under this permit only include electrical wiring rough-in of the system.An additional
<br /> Fire Alarm Permit is required for review of device location and installation approval.
<br /> ❑Other(List All):
<br /> MZXx�i.'; r s•� x+ff 5,�,.jerr ypl�a. C 3`� t i.,^` 3T kt O/� A;�`1'YJ, tMP .. C ;��tP 1Y�rt {er, vctz3�, r.: ;p� Q'
<br /> r ...,..T.. �..r........r? (,,..:...i: ?,:..�..:.e ..s... : }1�.x l .k Y.,3.{.'� 'P" /P�Yf�YO.`.PPANPgfad4,(Ei't§>p�Yl�jt,Y'jY SF,;,.n.`l y,�j7y , }�1{u �'�`SMA F�attA�h yl4 .
<br /> IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: EO YES—See Below&Pg.2
<br /> aBy checking this box, I am stating that I have read and understand all of WAC 296-46B-901,selected the specific reason on page 2
<br /> of this application(see next page),AND Plan Review is NOT required because I meet all of the followi g sub sections that do not
<br /> See Page 2 require Plan Review.
<br /> ARE YOU AN OWNER PERFORMING WORK AS THE CONTRACTOR WITHOUT ELECTRICAL LICENSURE: O EYES-See Below&Pg.3
<br /> 1-71 Pursuant to RCW 19.28.261,property owners and leaseholders cannot perform electrical work on ildings for rent,sale,or lease
<br /> without the proper electrical licensing and certification,or exemption. By checking this box, I am stating that I have completed and
<br /> See Page 3 signed the AFFIDAVIT on page 3 of this application to receive an exemption from this licensing/certification requirement.
<br /> {t{„ J.:1niY s S v;�K.�t�ty�r S'+'t. F �, te.§x e .Ury�h'iir ( ? vir.'/�� -!.�." t` z�*r ,. ..�{�. ..�+■. y�...�r inr+ :nx, ,. F r ^�:,z t e..t,�...gy...,:.
<br /> i� g$7. r-F<.;<5:>,9 r t r.K.+�A:,br:5,y��-'L?',4 3'f ri}fM1 11 s.,i i T�1> , O r51 TisItlf :K171A�d1"APP.{i'�Ar'{u1 t'vi i'':7 w1^� �-i �1 x�t�,•?', 4`r.,s,l Ifc,' , e l.�J,lv�?1` Ilv�.a%
<br /> : r,.. ...?J,ti~'k�. ,:�,,. n..A1SJ,£,z... .,...,,v:x,.,..,...�,.,k..�. ,.>��.., ...t„ �, r.,, ..,a..�.,._.< ,..�s„�.7.u�ttn�,U,..�. 4.�.�{M.r;r,�lo-+ ')„s�6.i?r ..s,�aio-' �:.. r r,"f�:�:?�a,ms)r4a i x: £t..
<br /> OWNER NAME: MARK WILSON TENANT BUSINESS NAME(lf Commercial):
<br /> OWNER MAILING ADDRESS: STREET 2304 8TH ST
<br /> cry EVERETT STATE WA ZIP 98201
<br /> OWNER PHONE:425-773-3608 OWNER EMAIL:M WILSON_7970@YAHOO.COM
<br /> CONTRACTOR NAME: GS HEATING, COOLING &ELECTRICAL LLC
<br /> CONTRACTOR ADDRESS: STREET 3409 EVERETT AVE
<br /> crrr EVERETT STATE WA zw, 98201
<br /> CONTRACTOR PHONE:425-610-4257 CONTRACTOR EMAIL:SARA@GSHEATING.COM
<br /> CONTRACTOR LIC.#(REQUIRED):GSl-IEAHC8218R CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 60058
<br /> PRIMARY CONTACT: DOWNER ❑✓CONTRACTOR ❑OTHER(Please Specify)
<br /> CONTACT NAME: CONTACT PHONE:425-610-4257
<br /> SARA HOLLAND CONTACT EMAIL:SARA@GSHEATING.COM
<br /> AGREEMENT:I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this
<br /> 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
<br /> local law regulating construction or the performance of construction. That 1 am authorized by the owner of this property to perform the work for which application is made and I
<br /> comply with the State Contractors Law 18.27 RCW and 298.200 WAC. City of Everett Official Use Only
<br /> PERMIT#:
<br /> { E
<br /> ,S a. kr i./ 'fir'.; .r � r: i v,
<br /> Owner/Authorized Agent Signature Date (Revised 1/11/2019) Page 1-Application
<br />
|