4626 RIVERFRONT BLVD 2020-12-23 - Laserfiche WebLink

ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES EVERETT 3200 CEDAR STREET. EVERETT,WA 98201 (P)425-257-8810 FAX 425-257-8857 I(E)everetteps4everettwa goy I www everettwa goy/permits VVASHINGTON • ' • ;'<T1' OROJECT SITE,INFORMATION PROJECT ADDRESS: 4626 Riverfront Blvd BUILDING AREA: sq ft PROJECT TYPE: 'A NEW CONSTRUCTION El ADDITION El TENANT IMPROVMENT LI REMODEL BUILDING USE: 171 SFR D TOWNHOUSE El DUPLEX [] ADO Li MULTI-FAMILY-#OF UNITS: fl COMMERCIAL CTRICAL APPLICATION INFORMATION &DESCRIPTION OF WORK CONTRACT PRICE OF WORK:$ 250 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: 100 amp temp power lot 369 THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? i NO E YES-Select Scope: LI Service El Feeder El Circuits-#: [3 Complete Re-wire LOW VOLTAGE WORK? [Z] NO El YES-#of Devices:„ SELECT SCOPE(REQUIRED) El Data LII Intercom 0 Thermostat 0 Audio 0 Secure Access El 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. El Other(List All): CODE COMPLIANCE IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: 171 NO El 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: WINO DYES-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. tONTACT INFORMATION , , OWNER NAME: Polygon Homes TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET 11624 SE 5th St Ste 100 Bellevue 98005 OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: Garner Electric WA LLC CONTRACTOR ADDRESS: sTREET 402 Valley Ave NW Ste 106 city Puyallup STATE WA zp 98371 CONTRACTOR PHONE:253-872-6051 CONTRACTOR EMAIL:agentele@gWeUSaCOM CONTRACTOR LIC.#(REQUIRED):GARNEEW864K8 CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 052909 enimArtv CONTACT, Elovumcp gloicaNTRAcTOR nOTHER(Please Specify) „ CONTACT NAME: CONTACT PHONE:253-278-7064 Paul Vantol CONTACT EMAIL:pvantolggweusecom AGREEMENT I 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 or 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 OM authorized by the owner of this property to perform the work for which application is made and I comply with the State Contractors sw 18 27 RCW and 296.200 WAC City of Everett Official Use Only PERMIT#: L9?). 12/26/2019 E kat \ Owner/Authorized Agent 41gnatur6 Date (RevIsect 1/1112019) Page 1-Application