2322 CEDAR ST 2021-11-01 - Laserfiche WebLink

imm ELECTRICAL PERMIT APPLIATION EVERETT CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 WASHINGTON (P)425-257-8810 I FAX 425-257-8857 l(E)everetteps@everettwa.gov I www.everettwa.gov/permits I IN r. 2 PROJECT ADDRESS: 2322 CEDAR STREET BUILDING AREA: 675 sq ft PROJECT TYPE: NEW CONSTRUCTION ❑ADDITION ❑TENANT IMPROVMENT ✓❑ REMODEL BUILDING USE: 0 SFR ❑TOWNHOUSE ❑ DUPLEX ❑ADU ❑ MULTI-FAMILY-#OF UNITS: CI COMMERCIAL CONTRACT PRICE OF WORK: $ 5400.00 ASSOCIATED BUILDING PERMIT#(if applicable) CW1809-00 DESCRIBE SCOPE OF WORK: REMODEL BEDROOM, BATH, LIVING, WET BAR. NEW OUTLETS, RECESSED LIG , SWITCHES THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ❑ NO ❑✓ YES-Select Scope: ❑Service ❑ Feeder ❑ Circuits-#: 14 ❑ Complete Re-wire LOW VOLTAGE WORK? ❑ NO ❑YES-#of Devices: SELECT SCOPE(REQUIRED) ❑ Data ❑ Intercom ❑Thermostat ❑Audio ❑ Secure Access ❑ Security System El 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): DOE COMPLIANCE IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: ✓❑ NO El 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 DYES-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. . � a FORMATIO OWNER NAME: JAMES CAUDLE TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET 2322 CEDAR STREET CITY EVERETT STATE WA Z,P 98201 OWNER PHONE:206-538-4159 OWNER EMAIL:g.macmillan.2@gmail.com CONTRACTOR NAME: R J CLARK LLC CONTRACTOR ADDRESS: STREET 19424 67TH AVE SE CITY SNOHOMISH STATE WA 98296 CONTRACTOR PHONE:206-510-8983 CONTRACTOR EMAIL:rjclarkllc@gmail.com CONTRACTOR LIC.#REQUIRED C-UkL)eCt.,SU �GITY OF EVERETT BUSINESS LIC.#(REQUIRED)A04126 ��ur.�.�. �,.. W,. .... -. ,, ...� -_____ s...�.. � PRIMARY CONTACT: ❑OWN ER OCONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:206-510-8983 ROB CLARK CONTACT EMAIL:rjclarkllc@gmail.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# . /� �t C ��%tA /i 7/24/19 E �J�' q\O rco 3 Owner/Authorized Agent Signature Date (Revised 1/11/2019) Page 1-Application