5307 COLLEGE AVE 2022-01-31 - Laserfiche WebLink

EVERETT WASHINGTON WCTRICAL PERMIT APPL�TION CITY OF EVERETT PERMIT SERVICE 3200 CEDAR STREET, EVERETT, WA 98201 (P) 425-257-8810 1 FAX 425-257-8857 1 (E) everetteps@everettwa.gov I www.everettwa.gov/permits \�2 PROJECT SITE INFORMATION PROJECT ADDRESS: 5307 College Ave, Everett WA 98203 BUILDING AREA: 1100 sq ft PROJECT TYPE: ❑ NEW CONSTRUCTION 0 ADDITION ❑ TENANT IMPROVMENT ❑ REMODEL BUILDING USE: 0 SFR ❑ TOWNHOUSE ❑ DUPLEX ❑ ADU ❑ MULTI -FAMILY - # OF UNITS: ❑ COMMERCIAL " ELECTRICAL' PLICATION INFORMATION 4, PESCRIPTION OF WUt CONTRACT PRICE OF WORK: $ $3,500.00 ASSOCIATED BUILDING PERMIT # (if applicable): DESCRIBE SCOPE OF WORK: 6.65kW PV System on roof. THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ❑ NO 0 YES - Select Scope: ❑ Service ❑ Feeder 0 Circuits-#: ❑ Complete Re -wire LOW VOLTAGE WORK? 0 NO ❑ YES- # of Devices: SELECT SCOPE (REQUIRED): ❑ Data ❑ Intercom ❑ 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): CODE COMPLIANCE IS THIS PERMIT EDUCATION, INSTITUTIONAL, HEALTH AND/OR PERSONAL CARE FACILITIES: 71 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: ;?I NO YES -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. CONTACT INFORMATION OWNER NAME: Matt Wright TENANT BUSINESS NAME (If Commercial): OWNER MAILING ADDRESS: STREET 5307 College Ave CITY Everett STATE WA ZIP 98203 OWNER PHONE: 206-391-1759 OWNER EMAIL: mattw@nwwindandsolar.com CONTRACTOR NAME: Self Install CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LIC. #(REQUIRED): CITY OF EVERETT BUSINESS LIC. #(REQUIRED): PRIMARY CONTACT: DOWNER ❑CONTRACTOR ❑OTHER (Please Specify) CONTACT NAME: Matt Wright CONTACT PHONE:206-391-1759 CONTACT EMAIL: m.wright1977@hotmail.com AGREEMENT: I 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 performance of construction. That 1 am authorized by the owner of this property to perform the work for which application is made and 1 comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only PERMIT #: a. W 9/30/2020 20� O S Owner/Authorized Agent Solature Date (Revised 1/1112019) Page 1-Application