2924 47TH ST SE 2022-05-23 - Laserfiche WebLink

® ELECTRICAL PERMIT APPLICATION EVERETT CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 waswir GTow (P) 425-257-8810 ( FAX 425-257-8857 1 (E) everetteps@everettwa.gov I mvw.everettwa.gov/permits �Rt ECT� lTE' N1 tRill#'k'ICt�11 PROJECT ADDRESS: 2924 47th St SE 7BUILDING AREA: sq ft PROJECT TYPE:✓❑ NEW CONSTRUCTION ❑ ADDITION ❑ TENANT IMPROVMENT ❑ REMODEL BUILDING USE: CI SFR ❑ TOWNHOUSE ❑ DUPLEX El ADU ❑ MULTI -FAMILY - # OF UNITS: ❑ COMMERCIAL NI:EC`iCtrl4 APpIl`C71', .N. IMF C�RMATitN'8 )lrfESCRIPTitlN OF WEiIEC CONTRACT PRICE OF WORK: $ 250 ASSOCIATED BUILDING PERMIT # (if applicable): DESCRIBE SCOPE OF WORK: 100 amp temp power Lot 359 THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? 0 NO ❑ YES - Select Scope: ❑ Service ❑ Feeder ❑ Circuits-#: ❑ Complete Re -wire LOW VOLTAGE WORK? Z 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 AII): CODE COMPLIANCE IS THIS PERMIT EDUCATION, INSTITUTIONAL, HEALTH ANDIOR 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 require Plan Review. ARE YOU AN OWNER PERFORMING WORK AS THE CONTRACTOR WITHOUT ELECTRICAL LICENSURE: ✓ NO YES -See Below & Pg. 3 Pursuant to RCW 19.28.261, property owners and leaseholders cannot perform electrical work on buildings for rent, sate, 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. 43NtA'T IIIt3RIW(ATION OWNER NAME: Polygon Homes TENANT BUSINESS NAME If Commercial): OWNER MAILING ADDRESS: sTI ET 11624 SE 5th St Ste 100 C,TY Bellevue ST.a,TE WA 98005 OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: Garner Electric WA LLC CONTRACTOR ADDRESS: ITIIET402 Valley Ave NW Ste 106 cm, Puyallup STI.TE WA 7,F 98371 CONTRACTOR PHONE:253-872-6051 CONTRACTOR EMAIL: Pvantol@gweusa.com CONTRACTOR LIC. #(REQUIRED): GARNEEW864K8 ICITY OF EVERETT BUSINESS LIC. #(REQUIRED): 052909 PRIMARY CONTACT' FlOWNER 7CONTRAC_TOR F- OTHPP (PI.... gpc ify) CONTACT NAME: "y t� Ca u { t v �/ a nto I I Paul CONTACT PHONE:253-278-7064 CONTACT EMAIL: pvantol@gweusa.com nvnccrv�civ r. 1 nareuy certrry uiei i nave reeu ano uxamitivu Gus appilcaiiun ano Know the same io oe true ano correct, All provisions or iawS ano orornances 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 stale or local law regulating construction or the performance of construction. That 7 am authorized by the owner of this property to perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only PERMIT #: r 1/1412020 E Owner/Authorized Agent Signs Wre Date (Revised 1/1112019) Page 1-Application