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10330 MERIDIAN AVE 2020-12-31
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10330 MERIDIAN AVE 2020-12-31
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12/31/2020 3:42:15 PM
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12/31/2020 3:42:11 PM
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Address Document
Street Name
MERIDIAN AVE
Street Number
10330
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• • <br /> 4/7"-r ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa,gov I www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: 10330 MERIDIAN AVE BUILDING AREA: sq ft <br /> PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ADDITION ❑TENANT IMPROVMENT ® REMODEL <br /> BUILDING USE: 0 SFR El TOWNHOUSE ❑ DUPLEX ❑ADU ❑ MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL <br /> ELECTRICAL APPLICATION INFORMATION & DESCRIPTION OF <br /> CONTRACT PRICE OF WORK:$3500 ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIBE SCOPE OF WORK: <br /> Panel change with meter base <br /> THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) <br /> LINE VOLTAGE WORK? ❑ NO ®YES-Select Scope: J❑ Service ❑ Feeder ❑Circuits-#: ❑Complete Re-wire <br /> LOW VOLTAGE WORK? ✓❑ NO ❑YES-#of Devices: <br /> SELECT SCOPE(REQUIRED): ❑ Data ❑ Intercom ❑Thermostat ❑Audio El 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 /> CODE'COMPLIANCE <br /> IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: ❑✓ 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: ENO EYES-See Below&Pg.3 <br /> Pursuant to RCW 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 /> "' CONTACT INFORMATION. 1'° <br /> OWNER NAME:Brian Elmore TENANT BUSINESS NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 10330 MERIDIAN AVE <br /> CTM Everett STATE WA Z,P98208 <br /> OWNER PHONE: 4253485846 OWNER EMAIL: belmore93@yahoo.com <br /> CONTRACTOR NAME: Switch Electric <br /> CONTRACTOR ADDRESS: STREET7226 139th Ave NE <br /> CITY STATE Stevens STATE WA ZIP <br /> 98258 <br /> CONTRACTOR PHONE:425-244-5511 CONTRACTOR EMAIL:service@ myswitchelectric.com <br /> CONTRACTOR LIC.#(REQUIRED):SWI I CEL91 PK CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 05255/ <br /> PRIMARY CONTACT: DOWNER ❑✓CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:253-376-7662 <br /> Tiffany Erickson <br /> CONTACT EMAIL:tiffany@myswltchelectrlc.com <br /> AGREEMENT:I 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/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#: t l I <br /> 11/18/19 E <br /> Owner/Authorized Agent Signature Date (Revised 1/11/2019) Page 1-Application <br />
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