8309 5TH AVE W 2021-02-25 - Laserfiche WebLink

• ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES #1111PW/CA,4477.1.. 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa gov I www.everettwa.gov/permits 0.1EC"I'SITE INFORMATION PROJECT ADDRESS: 8309 5th Avenue West BUILDING AREA,. 6 I tiCa,5 so ft PROJECT TYPE: 'Z NEW CONSTRUCTION ❑ADDITION ❑TENANT IMPROVMENT ❑REM00 BUILDING USE: ❑SFR ❑TOWNHOUSE ❑ DUPLEX ❑ADU 0 MULTI-FAMILY-#OF UNI 1 ❑COMMERCIAL ELECTRICAL APPLICATION INFO iMATION & DESCRIP!'� .,. CONTRACT PRICE OF WORK:$ 6,907.00 ASSOCIATED BUILDING PERMIT#(if applicable): C1701-012 DESCRIBE SCOPE OF WORK: Wire apartment to code. THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ❑ NO 7 YES-Select Scope: 0 Service 0 Feeder 0 Circuits-#:15 ❑Complete Re-wire LOW VOLTAGE WORK? ❑ NO 0 YES-#of Devices:3 SELECT SCOPE(REQUIRED): 0 Data ❑ Intercom ❑Thermostat ❑Audio El Secure Access ❑ Security System 0 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): CODE, PUANCE , IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: L„I NO El YES--See Below&Pg.2 By checking this box, I am stating that I have read and understand all of WAC 296-468-900,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. ��.. ..... 71 <IN PORMATI I OWNER NAME: Seattle Development Assoc., LLC TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET 1 122 130th Street SE -#A ci v Everett STATE WA zic 98208 OWNER PHONE:206-830-0126 OWNER EMAIL:SDAhomes@gmail,com ... CONTRACTOR NAME: Tughan Electric, Inc. CONTRACTOR ADDRESS: STREET1911 235th Court NE Sammamish STATE WA j P 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 ECONTRACTOR LIOTHER(Please Specify) CONTACT NAME: ( (� CONTACT PHONE:206-830-0126 EdI`s Kulaga CONTACT EMAIL:ecliskulaga@gmai(.com AGREEMENT I hereby certify that I have read and examined this application.and know the same to be true and correct. Alt 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 performance of construction. That I am authorized by the owner of this property to perform the work for which application is made and i comply with the S Contractor aw 18.27 RCW and 296.200 WAC. City of Everett Official Use Only PERMIT#: 1/29/2019 E (. c( 2 Owner/Author gent Signature Date (Revised 1/11/2019) Page 1-Application