10225 HOLLY DR 2021-11-12 - Laserfiche WebLink

MIMI 0 �TION LI ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES EVERETT 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 4 r. .zt 3 ,... x PRoJECr1's'SITE',lNFORMATIO14 - .tA 1. , , , i , PROJECT ADDRESS: 10225 Holly Dr. Everett, WA 98204 BUILDING AREA: 1800 sq ft PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ADDITION 0 TENANT IMPROVMENT ❑ REMODEL BUILDING USE: 0 SFR ❑TOWNHOUSE El DUPLEX ❑ADU ❑ MULTI-FAMILY-#OF UNITS: ❑ COMMERCIAL , Zfai i,. 14.:EL:ECTR>ICAL APPLICATION,,I(NFORMATI O DES RIPTIONL O.Rcnw . . iiii.° -_ CONTRACT PRICE OF WORK:$ 1300 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: Upgrade existing zinco breaker panel to new breaker panel and relocate to exterior wall also add 120V branch circuit for fridge THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ❑ NO 0 YES-Select Scope: Ei Service ❑ Feeder ❑ Circuits-#: ❑Complete Re-wire LOW VOLTAGE WORK? 0 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 Alp: .• ie : l F.e :. CODE COMPLIANCE,°: 1 .. a ... ,,.t til IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: El 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 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, 5 fi s A,. `CpNTACT`INPCRMATiQN .,. ,i.;,' .. fi` , �MM .•cd_ a v ...-R'-b °mom. � ..... _ .. - OWNER NAME: Carol Toikka TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET 10225 Holly Dr. CITY Everett, STATE WA zie 98204 OWNER PHONE:425-268-1351 OWNER EMAIL:carroltoikka@gmail.com CONTRACTOR NAME: Rhema Electric, LLC CONTRACTOR ADDRESS: sTREET628 S. Spruce St. cm, Burlington, STATE WA z,p 98233 CONTRACTOR PHONE: 360416-8227 CONTRACTOR EMAIL: davea@rhemaelectric.com CONTRACTOR LIC.#(REQUIRED):RHEMAEL940DH CITY OF EVERETT BUSINESS LIC.#(REQUIRED):45783 PRIMARY CONTACT: [DOWNER ECONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 360-391-1884 Dave Al a n iz CONTACT EMAIL: davea@rhemaelectric.com AGREEMENT:Thereby 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 wilt be completed whether specified heroin or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other stale 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 1 co 'h he State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only PERMIT#: lo �� E2-Cm -- 02 � i._.OvinerlAuthorl ed Agent Signature Date (Revised 1/11/2019) Page 1•ApplicatIon