4733 GLENWOOD AVE 2021-11-12 - Laserfiche WebLink

• mai 16.Riivaa I "I—r si..jvra II itvsv EVERETT CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 wasHiwsrow (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.govtpermits p - „. � � PROJECT ADDRESS: 4733 Glenwood Ave Everett 98203 BUILDING AREA: so ft PROJECT TYPE: Li NEW CONSTRUCTION ❑ADDITION TENANT IMPROVMENT ❑REMODEL BUILDING USE: 0 SFR ❑TOWNHOUSE ❑DUPLEX ❑ADU ❑MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL CONTRACT PRICE OF WORK:$ 1000.00 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: AC installation THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? Q NO ❑✓ YES-Select Scope:❑Service ❑Feeder ❑Circuits-#:2 ❑Complete Re-wire LOW VOLTAGE WORK? 0 NO ❑YES-#of Devices: SELECT SCOPE(REQUIRED): ❑Data ❑ Intercom ❑Thermostat u 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): IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: �' NO YES--See Below&Pg.2 t t 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: ENO EYES-See Below&Pg.3 i___I 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. OWNER NAME: Craig SWaffard TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET 4733 Glenwood Ave cnv Everett STATE WA aP 98203 OWNER PHONE:425 359 5121 [OWNER EMAIL: CONTRACTOR NAME: Skyline Electrical Services CONTRACTOR ADDRESS: sTRee-r113 Cherry St#75215 CITY Seattle STATE WA zip 98104 CONTRACTOR PHONE:4255-201-8288 CONTRACTOR EMAIL:wende@skylinelectric.com CONTRACTOR LIC.#(REQUIRED):SKYLIES820RD CITY OF EVERETT BUSINESS LIC.#(REQUIRED):60163 PRIMARY CONTACT: DOWNER ©CONTRACTOR []OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:425_626-3679 Alex CONTACT EMA!L:aiex@skylinelectric.com AGREEMENT:thereby certify that f 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 1 am authorized by the owner of this property to perform the work for which application is made and l comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only PERMIT#: L___41)tk-teav•-tS 2 E eck,o Owner/Authorized Agent Signature Date (Revised 1/11/2019) Pagel-Application