1715 GRAND AVE 2022-02-08 - Laserfiche WebLink

• • ELECTRICAL PERMIT APPLICATION 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 77 I IiO IEC 1�" ; I_,�MFORMATIW PROJECT ADDRESS: 1715 GRAND AVE BUILDING AREA: 00438034400600 sq ft PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ ADDITION ❑ TENANT IMPROVMENT ✓❑ REMODEL BUILDING USE: ❑✓ SFR ❑ TOWNHOUSE ❑ DUPLEX ❑ ADU ❑ MULTI -FAMILY - # OF UNITS, ❑ COMMERCIAL ELECTRICAL AP4'.LICATION INi ORMATIO I A„,iL ... I TIt11+i:OFFWORK_ CONTRACT PRICE OF WORK: $ 250 ASSOCIATED BUILDING PERMIT # (if applicable): DESCRIBE SCOPE OF WORK: ADD CIRCUIT FOR DUCTLESS HEAT PUMP INSTALL THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ❑✓ NO ❑ YES - Select Scope: ❑ Service ❑ Feeder © Circuits-#: 1 ❑ 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): COPE 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 296-46B-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 requite Plan Review. ARE YOU AN OWNER PERFORMING WORK AS THE CONTRACTOR WITHOUT ELECTRICAL LICENSURE; ZNO 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. 77, WCONTACT INOItMATIOM R;. OWNER NAME: SEAN GOLDFINCH TENANT BUSINESS NAME If Commercial : OWNER MAILING ADDRESS: STREET 1715 GRAND AVE ,, , EVERETT STATE WA zip 98201 OWNER PHONE: 425-327-2265 OWNER EMAIL: seang@goldfinchbros.com CONTRACTOR NAME: C.M. HEATING INC CONTRACTOR ADDRESS: STReET 1415 BROADWAY cirr EVERETT STATE WA zip 98201 CONTRACTOR PHONE:425-259-0550 CONTRACTOR EMAIL: KAILANA@CMHEATING.COM CONTRACTOR LIC. #(REQUIRED): CMHEAMH877DN CITY OF EVERETT BUSINESS LIC, #(REQUIRED): 016098 PRIMARY CONTACT: DOWNER ©CONTRACTOR ❑OTHER (Please Specify) CONTACT NAME: KAILANA MONIZ CONTACT PHONE:425-259-0550 CONTACT EMAIL:KAILANA@CMHEATING.COM AUREt1v9PN V I twfeby certify that I have read and examined thrs application 00d know (fie same to be true and correct, All PrOWSMS Of Iaw3 and oraWances gcvernrhg W4 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 WAG. ?witty of Evereft Official Use Only L —..✓Y .4LO Y 08/21/19 E lCT Owner/Authorized Agent Signature 4V Date (Revised 1/1112019)Page I -Application