8301 5TH AVE W 2022-02-28 - Laserfiche WebLink

• ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 FAX 425-257-8857 I(E)everetteps@everettwa.gov l w"vw.everettwa.gov/permits PROJECT ADDRESS: 8301 5th Avenue West BUILDING AREA: 1 Ll[Q5 sq ft PROJECT TYPE: NEW CONSTRUCTION ❑ADDITION ❑TENANT IMPROVMENT ❑ REMODEL ! BUILDING USE: ❑SFR El TOWNHOUSE ❑ DUPLEX ❑ADU D MULTI-FAMILY-#OF UNITS:1 COMMERCIAL AI.AP J ICATION INFORMATION & DESCRIP'". WORK CONTRACT PRICE OF WORK:$ 6,907.00 ASSOCIATED BUILDING PERMIT#(if applicable): C1701-008 DESCRIBE SCOPE OF WORK: Wire-apartment-t i code. ci- THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ❑ NO Ly YES-Select Scope: El Service 0 Feeder l Circuits-#:15 ❑Complete Re-wire LOW VOLTAGE WORK? ❑ NO D YES-#of Devices:3 SELECT SCOPE(REQUIRED): ✓❑ Data ❑ Intercom El Thermostat ❑Audio ❑Secure Access ❑ Security System 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): T • IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: ILi 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:ONO 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. MA.T� OWNER NAME: Seattle Development Assoc., LLC TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET 1122 130th Street SE-#A c n Everett STATE WA ziR 98208 OWNER PHONE:206-830-0126 OWNER EMAIL:SDAhomes@gmail.com CONTRACTOR NAME: Tughan Electric, Inc. CONTRACTOR ADDRESS: STREET 191 1 235th Court NE cry Sammamish STATE WA z, 98074 CONTRACTOR PHONE:425-868-8072 CONTRACTOR EMAIL:Larry@tughanelectric.com CONTRACTOR LIC.#(REQUIRED):TUGHAEl943BP CITY OF EVERETT BUSINESS LIC.#(REQUIRED):044481 PRIMARY CONTACT: DOWNER ❑CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: �I CONTACT PHONE:206-$3Q-0126 EdiS KuIj aga CONTACT EMAIL:edi$kulagacrgmaiLcom AGREEMENT:t 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 rformance of construction, That I am authorized by the owner of this property to perform the work for which application is made and t comply with the State' ontractors L 18.27 RCW and 296.200 WAG. City of Everett Official Use Only PERMIT#: E �� 0 1 - _� �W. 1/29/2019 Owner/ uth riz Ag t Signature Date (Revised 1/11/2019) Page 1-Application