8305 5TH AVE W 2021-02-25 - Laserfiche WebLink

• ELECTRICAL PERMIT APPLICATION Imo►' CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 I(E)everettepsieverettwagov I www.everettwa.gov/permits PROJECTPRO4ECT,WW041MRNI4T1014'. PROJECT ADDRESS: 8305 5th Avenue West BUILDING AREA: 1,096 sq ft PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ADDITION ❑TENANT IMPROVMENT ❑REMODEL BUILDING USE: ❑SFR ❑TOWNHOUSE E DUPLEX ❑ADU [l MULTI-FAMILY-#OF UNITS:1 COMMERCIAL ..:� E‘EtTiti 7.0414fIVION & 1:),ESCAPTION OF WORK CONTRACT PRICE OF WORK:$ 6,907.00 ASSOCIATED BUILDING PERMIT#(if applicable) C1701-010 DESCRIBE SCOPE OF WORK: Wire apartment to code, THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ❑ NO E YES-Select Scope: Service El Feeder D Circuits-#:15 ❑ Complete Re-wire LOW VOLTAGE WORK? ❑NO ✓❑YES-#of Devices:3 SELECT SCOPE(REQUIRED). ❑Data El Intercom ❑Thermostat ❑Audio ❑Secure Access El 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). ODE COMPLIANCE IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: Q NO ❑YES--See Below&Pg.2 By checking this box I am stating that I have read and understand all of WAG 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: iY iNO 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. OWNER NAME: Seattle Development Assoc., LLC TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET 1122 130th Street SE.-#A cm Everett STATE WA ZIP 98208 OWNER PHONE:206-830-0126 OWNER EMAIL:SDAhomes@gmail.Com CONTRACTOR NAME: Tughan Electric, Inc. CONTRACTOR ADDRESS: STREET1911 235th Court NE cm., Sammamish STATE WA Z;F 98074 CONTRACTOR PHONE:425-868-8072 CONTRACTOR EMAIL:Larry@tughanelectriC.com CONTRACTOR LIC.#(REQUIRED):TUGHAE1943BP CITY OF EVERETT BUSINESS LIC.#(REQUIRED):044481 .. PRIMARY CONTACT: DOWNER n.CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: as (} CONTACT PHONE:206-830-0126 Ed Kulaga CONTACT EMAIL:ediskulaga@gmail.com AGREEMENT:/hereby certify that I have read and examined this application and know the same to be tale and correct. All provisions of laws and ordinances governing this type of work will be completed whether specified herein or not The granting eta 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 try the owner of this property to perform the work for which application is made and I corn the S Contract Law 18,27 RCW and 296.200 WAC. City of Everett Official Use Only PERMIT#: 1/29/2019 E Owner/Au orize gent Signature Date (Revised 1/17/2019) Page 1-Application