2402 CLEVELAND AVE 2021-11-01 - Laserfiche WebLink

• II ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 j FAX 425-257-8857 1(E)everetteps@everettwa.gov I www.everettwa.gov/pemmits 47:47.7 PROJECT.SITE.INFORMATION.. PROJECT ADDRESS: 2402 CLEVELAND AVE BUILDING AREA: sq ft PROJECT TYPE: ❑ NEW CONSTRUCTION Z ADDITION ❑TENANT IMPROVMENT ❑ REMODEL BUILDING USE: ❑✓ SFR ❑TOWNHOUSE DUPLEX ❑ADU El MULTI-FAMILY-#OF UNITS: El COMMERCIAL ELECTRICAL.AP. ,ATION INFORMATION &,DESCRIPTION OP:WORK CONTRACT PRICE OF WORK:$ 4.27 , ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: GAS FURNACE REPLACEMENT THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? El NO El YES-Select Scope:El Service El Feeder ❑✓ Circuits-#:1 ❑Complete Re-wire LOW VOLTAGE WORK? ❑NO ❑✓ YES-#of Devices: SELECT SCOPE(REQUIRED): ❑Data El Intercom '1 Thermostat ❑Audio El 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. El Other(List All); DE COMPLIANCE IS THIS PERMIT EDUCATION,INSTITUTIONAL HEALTH AND/OR PERSONAL CARE FACILITIES: 0 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: LJNO OYES-See Be:ow&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 en exemption from this licensing/certification requirement. • CONTACT;INFORMATION OWNER NAME: GREG TAIT TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET 2402 CLEVELAND AVE crTu EVERETT STATE WA zip 98201 OWNER PHONE:4252205934 OWNER EMAIL:GREG_TAIT@COMCAST.NET CONTRACTOR NAME: gs heating CONTRACTOR ADDRESS: srneET3409 eVerett ave cr- everett STATE wa ZIP 98201 CONTRACTOR PHONE:425-252-4402 CONTRACTOR EMAIL:ALISHA@gsheating.com CONTRACTOR LIC.#{REQUIRED):GSHEAHC8218R CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 60058 PRIMARY CONTACT: [DOWNER ❑✓CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:425-252-4402 AL IS HA CLOGSTON CONTACT EMAIL:ALISHA@gsheating.com AGREEMENT I hereby certify that!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 cf any other state or local law regulating construction or the performance of construction. That t 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 ROW and 296.200 WAG. City of Everett Official Use Only PERMIT#:q ALISHA CLOGSTON E \ CD - 2.m 2 OwneriAuttiorized Agent Signature Date (Revised 1/11/2019) Page 1-Application