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0 <br />Illllllll� <br />ELECTRICAL PERMIT APPLICATION <br />EVERETT CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />WAS AINGrON (P) 425-2.57-8810 1 FAX 425-257-8857 1 (E) everetteDS(Qeverettwa aov I wwwevarettwp nnvinprmtle <br />PROJECT SITE INFORMATION <br />PROJECT ADDRESS: 6305 W Beech St IBUILDING AREA; sq ft <br />PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ ADDITION © TENANT IMPROVMENT ❑ REMODEL <br />BUILDING USE: 1ZSFR ❑ TOWNHOUSE ❑ DUf'LEX ❑ ADU ❑ MULTI -FAMILY - # OF UNITS:. ❑ COMMERCIAL <br />ELECTRICAL APPLICATION INFORMATION & DESCRIPTION OF WORK <br />CONTRACT PRICE OF WORK: $ 4000 ASSOCIATED BUILDING PERMIT # (if applicable): <br />DESCRIBE SCOPE OF WORK: <br />Remove existing 200 amp panel and replace with new 200 amp panel. Add 100 amp feeder. <br />THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) <br />LINE VOLTAGE WORK? ❑ NO ❑✓ YES - Select Scope: ❑✓ Service ✓❑ Feeder ❑ Circuits-#: ❑ Complete Re -wire <br />LOW VOLTAGE WORK? ❑✓ NO ❑ YES- # of Devices <br />SELECT SCOPE (REQUIRED) ❑ Data ❑ Intercom ❑ Thermostat ❑ Audio ❑ Secure Access ❑ Security System <br />El Fire Alarm - Installations under this permit only include electrical wiring rough -in of the system An additional <br />Fire Alarm Permit is required for review of device location and installation approval <br />❑ Other (List All). <br />CODE COMPLIANCE <br />IS THIS PERMIT EDUCATION, INSTITUTIONAL, HEALTH AND/OR PERSONAL CARE FACILITIES: ✓ NO YES -- See Below & Pg 2 <br />10 By checking this box, I arty staling that I have read and understand all of WAC 296-468-900, selected the specific mason on page 2 <br />of this application (see next page), AND Plan Rovi w is NOT required aecause i meet all of ttie [�lIloviny sub sections that do not. <br />See Page 2 require Plan Review <br />ARE YOU AN OWNER PERFORMING WORK AS THE CONTRACTOR WITHOUT ELECTRICAL LICENSURE: UNO YES -See Below & Pg 3 <br />Pursuant to RCW 19 78 261, property owners anf: leasehollem cannot perform electricat w rk on buildings lot rent, -sale, or lease <br />without the proper electricat licensing atO certification, or exemption By checking th s hox, I am itxat I have complotod and <br />See Page 3 signed the AFFIDAVIT on page 3 of this application to receive an exemption from this licensing/certification requirement <br />CONTACT INFORMATION <br />OWNER NAME: Wayne Opple TENANT BUSINESS NAME (If Commercial): <br />OWNER MAILING ADDRESS: STREET 6305 W Beech St <br />City Everett STATE WA 98203 <br />OWNER PHONE: 425-355-0670 <br />OWNER EMAIL: kalaniOpple@COmCaSt.net <br />CONTRACTOR NAME: E & E Electric, Inc. <br />CONTRACTOR ADDRESS: STREET 23826 35th Ave W <br />cnr Brier STATE WA z,P 98036 <br />CONTRACTOR PHONE:425-478-3991 <br />CONTRACTOR EMAIL: eeelectric@Comcast.net <br />CONTRACTOR LIC. #(REQUIRED): EEELEI*981JK <br />CITY OF EVERETT BUSINESS LIC. #(REQUIRED): 60831 <br />PRIMARY CONTACT: [—]OWNER ❑✓ CONTRACTOR ❑OTHER (Please Specify)„ <br />CONTACT NAME: <br />Jay ECjgelJfaaten'CONTACT <br />CONTACT PHONE:425-478-3991 <br />EMAIL: eeelectric@comcast.net <br />.-- ..,.....�. --.-.j .•a ..a . a.v: vcv a w una,nr .wu a+r ¢N rrc:n�rcva gvlu �,Fr6w {nC same to Oe true, Roe Correct:. AN P V1330fi , :7f 4xw $ and (NIJieca ni;*$.tQ*j*'r. ,ny 1:hrg <br />type of work will be completed whether specified herein or not rho granting of a permH does net presume to give authority to violate or cancel the provisions of any other state or <br />local law regulating construction or the performance of construction chat t am authorized by the owner of this property to perform the work for which application is made and t <br />comply with the State Contractors Law 18 27 RC W and 296 200 WAC Ctt�r of Erieratt Ofitci at U%jt 011Y <br />1'ERIvU'T# ,a <br />_ E <br />'DwIlnrthuttlonized Agent bignature °)ern ('Revised 1/11/2019) Page 1-Application <br />