1525 FLORIDA DR 2022-04-15 - Laserfiche WebLink

ELECTRICAL PERMIT APPLICATION EVERETT CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 WASHINGTON (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 1 525 Florida Dr BUILDING AREA: 2000 sq ft PROJECT TYPE: ❑✓ NEW CONSTRUCTION El ADDITION ❑TENANT IMPROVMENT ❑ REMODEL BUILDING USE: ❑✓ SFR ❑ TOWNHOUSE El DUPLEX ❑ADU ❑ MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL ELECTRICAL APPLICATION INFORMATION 81, DESCRIPTION OF.,WORK CONTRACT PRICE OF WORK:$ 8900.00 ASSOCIATED BUILDING PERMIT#(if applicable): C1906-015 DESCRIBE SCOPE OF WORK: Wire new sfr THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ❑ NO ❑✓ YES-Select Scope: ✓❑ Service ✓❑ Feeder ❑✓ Circuits-#:14 ❑ Complete Re-wire LOW VOLTAGE WORK? ❑ NO ❑✓ YES-#of Devices:6 SELECT SCOPE(REQUIRED): ✓❑ Data ❑ 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): CODE'COMPLIANCE IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: ✓❑ NO ❑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 EYES-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 "h OWNER NAME: Bustard Custom Construction TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET PO Box 1243 CITY Marysville STATE WA ZIP 98270 OWNER PHONE:4258766551 OWNER EMAIL:bustardcustomconstruction@gmail.com CONTRACTOR NAME: Lake Stevens Electric LLC CONTRACTOR ADDRESS: STREET5714 95th Ave NE CITY Lake Stevens STATE WA ZIP 98208 CONTRACTOR PHONE:4253277447 CONTRACTOR EMAIL:lakestevenselectric@gmail.com CONTRACTOR LIC.#(REQUIRED):LAKESSE840C3 CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 55490 PRIMARY CONTACT: DOWNER ❑✓CONTRACTOR ['OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:4253277447 Steve Varnel I CONTACT EMAIL:lakestevenselectric@gmail.com 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 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 work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only PERMIT#: Steve Varnell 5/26/2020 E 2005-121 Owner/Authorized Agent Signature Date (Revised 1/11/2019) Page 1-Application