512 72ND ST SE 2021-12-22 - Laserfiche WebLink

*ELECTRICAL PERMIT APP•CATION 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: 512 72ND ST SE BUILDING AREA: 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: $ 17078.82 ASSOCIATED BUILDING PERMIT # (if applicable): DESCRIBE SCOPE OF WORK: INSTALL ROOFTOP PHOTOVOLTAIC SYSTEM WITH TESLA POWERWALLS AND AUTO -TRANSFER SWITCH FOR NON -CRITICAL BACK UP POWER. THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ❑ NO ❑✓ YES - Select Scope: ✓❑ Service ✓❑ Feeder ❑ Circuits-#: ❑ 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): CODE COMPLIANCE IS THIS PERMIT EDUCATION, INSTITUTIONAL, HEALTH AND/OR PERSONAL CARE FACILITIES: W1 NO LJ 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 ❑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: JAMES VAIL TENANT BUSINESS NAME (If Commercial): OWNER MAILING ADDRESS: STREET 512 72ND ST SE c,n EVERETT STATE WA 1,98203 OWNER PHONE: 206-949-9517 OWNER EMAIL: JAMES.1.VAIL@MAC.COM CONTRACTOR NAME: SUNERGY SYSTEMS INC CONTRACTOR ADDRESS: sTREET4546 LEARY WAY NW c,TY SEATTLE STATE WA ... 98107 CONTRACTOR PHONE: 206-571-4726 CONTRACTOR EMA L JONL@SUNERGYSYSTEMS.COM CONTRACTOR LIC. #(REQUIRED): TY F EVERETT BUSINESS LIC. #(REQUIRED): PRIMARY CONTACT: ❑OWNER ZCONTRACTOR ❑OTHER (Please Specify) CONTACT NAME: J O N LAN G E CONTACT PHONE: 206-571-4726 CONTACT EMAIL: JONL@SUNERGYSYSTEMS.COM murNccivicry i. i nereuy cenny mar i nave reao ano examrnea mis appicaoon and Know me same TO oe true and correct. All provisions or 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#: 7/9/2020 E -Co ` vJ Own Authorized AgerW Signature Date (Revised 111112019) Page 1-Application