Laserfiche WebLink
• • <br /> OOP ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> PROJECT EMI INFORMATION <br /> PROJECT ADDRESS: 3013 Gedney Vella �j, t BUILDING AREA; 960 sq ft <br /> PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ADDITION ❑TENANT IMPROVMENT ✓❑REMODEL <br /> BUILDING USE: SFR El TOWNHOUSE ❑DUPLEX ❑ADU ❑MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL <br /> ELECTRICAL APPLICATION IN O NEA" 9 ,_ ?._S l TION'';OF\ <br /> CONTRACT PRICE OF WORK:$ 500 ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIBE SCOPE OF WORK: <br /> 20AMP Dedicated Circuit for Heat Pump <br /> THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) <br /> LINE VOLTAGE WORK? ❑ NO ❑YES-Select Scope:❑Service El Feeder Q Circuits-#:1 ❑Complete Re-wire <br /> LOW VOLTAGE WORK? ❑ NO ❑YES-#of Devices: <br /> SELECT SCOPE(REQUIRED): El Data ❑ Intercom E Thermostat ❑Audio El Secure Access ❑Security System <br /> El 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 /> IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: CI NO ❑YES--See Below&Pg.2 <br /> ❑ 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 <br /> of this application(see next page),AND Plan Review is NOT required because I meet all of the following 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: EINO EYES-See Below&Pg.3 <br /> l I Pursuant to ROW 19.28.261,property owners and leaseholders cannot perform electrical work on buildings 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 /> OWNER NAME; Ray Murphy TENANT BUSINESS NAME(If Commercial): - <br /> OWNER MAILING ADDRESS: STREET 3013 Gedney Ave SE <br /> Everett STATE WA ZIP 98201 <br /> OWNER PHONE:425-445-0619 OWNER EMAIL:rey.mrphy@yahoo.Com <br /> CONTRACTOR NAME: SeaTown Electric Corp. <br /> CONTRACTOR ADDRESS: STREET 3431 Broadway <br /> CITY Everett STATE WA ZIP 98201 <br /> CONTRACTOR PHONE:206-905-4946 CONTRACTOR EMAIL:Permits@seatownservices.com <br /> CONTRACTOR LIC.#(REQUIRED):SEATOEC86ORB CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 53916 <br /> PRIMARY CONTACT: DOWNER ❑✓CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:206-905-4946 <br /> Be ka h Swanson CONTACT EMAIL:permits@seatownservices.com <br /> AGREEMENT 1 hereby certify that 1 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 296.200 WAC City of Everett Official Use Only <br /> PERMIT#: ,. <br /> 6/19/19 E 1010 n &f I�2 <br /> Owner/A h rized!*r (nature Date (Revised 1/11/2019) Page 1-Application <br />