824 W CASINO RD BLDG B 2021-11-01

E ECTRICAL PERMIT APPLIATION EVERETT CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 WASHiNGTON (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits ""ORMATI PROJECT ADDRESS: 824 West Casino Rd Unit B9 BUILDING AREA: 950 sq ft PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ADDITION ❑ TENANT IMPROVMENT ✓❑ REMODEL BUILDING USE: El SFR ❑TOWNHOUSE ❑ DUPLEX ❑ADU ✓❑ MULTI-FAMILY-#OF UNITS: 1 ❑COMMERCIAL EL.EcTRU' =. CATION INFORMATION & DESCRIPTION OF WORK 1 CONTRACT PRICE OF WORK:$ 6500 ASSOCIATED BUILDING PERMIT#(if applicable): 1 11'0D-O'2 / 1 DESCRIBE SCOPE OF WORK: // Demo panel and damaged wiring, install new 100A meter main breaker panel, re-use existing panel feeder. Re-wire damaged circuits due to fire. THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? El NO ❑✓ YES-Select Scope: ❑ Service ❑ Feeder ❑✓ Circuits-#: 12 ❑ Complete Re-wire LOW VOLTAGE WORK? ❑✓ NO El YES-#of Devices: SELECT SCOPE(REQUIRED): ❑ Data ❑ Intercom El 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: ✓❑ 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: ONO EYES-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: Interstate Restoration TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET CITY STATE ZIP OWNER PHONE:817-293-0035 OWNER EMAIL: CONTRACTOR NAME: Garner Electric WA LLC CONTRACTOR ADDRESS: STREET402 Valley Ave NW Ste 106 CITY Puyallup STATE WA ZIP 98371 CONTRACTOR PHONE:253-872-6051 CONTRACTOR EMAIL:ktaylor©gweusa.com CONTRACTOR LIC.#(REQUIRED):GARNEEW864KB CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 052909 PRIMARY CONTACT: DOWNER OCONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:253-872-6051 Bill Gentele CONTACT EMAIL:bgentele@gweusa.com AGREEMENT:I hereby certify that I have read and examined this 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 I 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#: ),VI CLe / E )(/( '' 9— o t ( Owner/Authori ed Agent Signature Dat (Revised 1/11/2019) Page 1-Application