4116 CLIFF DR 2022-01-26 - Laserfiche WebLink

RECTRICAL PERMIT APPLICATION EVERETT WASHINGTON CITY OF EVERETT PERMIT SERVICES 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 PROJECT SITE INFORMATION PROJECT ADDRESS: 4116 Cliff Drive BUILDING AREA: 2994 sq ft PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ ADDITION ❑ TENANT IMPROVMENT ✓❑ REMODEL BUILDING USE: ❑✓ SFR ❑ TOWNHOUSE ❑ DUPLEX ❑ ADU ❑ MULTI -FAMILY - # OF UNITS: ❑ COMMERCIAL ELECTRICAL APPLICATION INFORMATION &'DESCRIPTION OF WORK CONTRACT PRICE OF WORK: $1500 ASSOCIATED BUILDING PERMIT # (if applicable): DESCRIBE SCOPE OF WORK: 1 (2) circuits added in garage for (2) 4 plex GFCI's THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ✓❑ NO ❑ YES - Select Scope: ❑ Service ❑ Feeder ❑✓ Circuits-#: 2 ❑ Complete Re -wire LOW VOLTAGE WORK? 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): 2 circuits added/altered CODE COMPLIANCE IS THIS PERMIT EDUCATION, INSTITUTIONAL, HEALTH AND/OR PERSONAL CARE FACILITIES: ✓ NO YES -- See Below & Pg. 2 ❑ By checking this box, I am stating that I have read and understand all of WAC 296-4613-900, 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: ✓ NO 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. CONTACTINFORMATION""," . OWNER NAME:KriSta Cromwell/Phil Cromwell TENANT BUSINESS NAME (If Commercial): OWNER MAILING ADDRESS: STREET 4116 Cliff Drive ,�,,,, Everett STATE WA Z,p 98203 OWNER PHONE: 214-304-6080 OWNER EMAIL: pcolberttx@gmail.com CONTRACTOR NAME: Good Sense Electric CONTRACTOR ADDRESS: STREET P.O. BOX 421 CITY Mukilteo STATE WA Z,p 98275 CONTRACTOR PHONE: 425-438-8738 CONTRACTOR EMAIL: carriew@goodsenseelectric.com CONTRACTOR LIC. #(REQUIRED): GOODSSE923D0 CITY OF EVERETT BUSINESS LIC. #(REQUIRED): 53371 PRIMARY CONTACT: DOWNER ❑✓ CONTRACTOR ❑OTHER (Please Specify) CONTACT NAME: Dave/Carrie CONTACT PHONE: 425-438-8738 CONTACT EMAIL:carriew@goodsenseelectric.com . aalvf=ly 1. 1 heieuy cediry that i have read and exammea tms 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/ am authorized by the owner of this property to perform the work for which application is made and / comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only PERMIT #: Carrie C. Willian 3/13/2020 I E 2- l 0y Owner/Authorized Agent Signature Date (Revised 1/1112019) Page 1-Application