4615 RIVERFRONT BLVD 2020-12-23 - Laserfiche WebLink

IMO 41 1 0 all ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES EVERETT 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 1 FAX 425-257-8857 1(E)everetteps@everettwa gov I www.everettwagoviperm4s WAStilt4WMN P -. '.... , ITE INFORMATION PROJECT ADDRESS: 4615 Riverfront Blvd 'BUILDING AREA: _sq ft ,.. PROJECT TYPE: A NEW CONSTRUCTION El ADDITION 0 TENANT IMPROVMENT 0 REMODEL BUILDING USE: I,71 SFR 7 TOWNHOUSE --I, DUPLEX L ADU [1 MULTI-FAMILY •#OF UNITS: 7 COMMERCIAL ELECTRICAL APPLICATION'INFORMATION &DESCRIPTION OF WORK CONTRACT PRICE OF WORK: $ 250 ASSOCIATED BUILDING PERMIT#of appItcable) DESCRIBE SCOPE OF WORK: 100 amp temp power Lot 304 THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? [ZI NO El YES-Select Scope:El Service El Feeder 0 Circuits4: 0 Complete Re-wire LOW VOLTAGE WORK? gl NO El YES-#of Devices. SELECT SCOPE(REQUIRED): F.:] Data El Intercom El Thermostat El Audio El Secure Access D Security System Ei 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 7 Other(List All): i';1A', '''''' :,,. .--''' ' ' — •':,„,, , ;', • ' , -- ',,„ !•A'4:,,,_ -• ,„,,,, .• •!: • :,: IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: NO El YES--See Below&Pg 2 By checking this box,I am stating that I have read and understand all of WAC 296-468-900,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:liZNO EYES-See Below&Pg 3 -1 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; Polygon Homes TENANT BUSINESS NAME Of Commercial): OWNER MAILING ADDRESS: STREET 11624 SE 5th St Ste 100 Bellevue , , , WA - 98005 OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: Garner Electric WA LLC CONTRACTOR ADDRESS: STREET 402 Valley Ave NW Ste 106 crry Puyallup STATE WA zo, 98371 CONTRACTOR PHONE:253-872-8081 CONTRACTOR EMAIL:agentele@gweusacom CONTRACTOR LIC.kREQUIRED):GARNEEW864KB CITY OF EVERETT BUSINESS LIC,#(REQUIRE0): 052909 PRIMARY CONTACT! DOWNER WICONTRACTOR 1710THER(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 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 th ate Contractors Law 6.27 ROW and 296.200 WAC City of Everett Official Use Only PERMIT# / i — 9/24/2019 E nice\ _ 42d\, Owner/Authorized Agent Sig ture Date (Revised 1/11/2019) Page 1-Application