1327 HOYT AVE 2021-11-15 - Laserfiche WebLink

• i ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 _ - i (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits , „ r•._ a tt "'.:�. _Y k 7'' '-,PRo E r I NV •, PROJECT ADDRESS: 1327 HOYT AVE BUILDING AREA: 2700 sq ft PROJECT TYPE: ❑NEW CONSTRUCTION ❑ADDITION ❑TENANT IMPROVMENT ❑REMODEL El BUILDING USE: ©SFR ❑TOWNHOUSE El DUPLEX El ADU El MULTI-FAMILY-#OF UNITS: COMMERCIAL ».. .* LECTI CJ4 p CAT O .: F M+ " Qi &: E : IIPT1ON OF WORK' :.:. CONTRACT PRICE OF WORK:$ 250 ASSOCIATED BUILDING PERMIT#(if applicable): ✓I DESCRIBE SCOPE OF WORK: , ADD CIRCUIT FOR A/C INSTALLATION THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) ..:....... t LINE VOLTAGE WORK? ©NO ❑YES-Select Scope:❑ Service El Feeder ©Circuits-#; 1 El Complete Re-wire LOW VOLTAGE WORK? ❑✓ NO El YES-#of Devices: SELECT SCOPE(REQUIRED): El Data ❑ Intercom © Thermostat ❑Audio ❑Secure Access El 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. El Other(List All): S 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 pa.ge 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 OYES-See Below&R9..3. flfPursuant to RCW 19.28.261,property owners and leaseholders cannot perform electrical work on buildings for rent,sale,or lease, I 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: BRIAN TRIMBLE TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET 1327 HOYT AVE - CITY EVERETT __. STATE WA ZIP.98201"- w.- ,,.. OWNER PHONE:206-947-8230 OWNER EMAIL:brian.trimble@gmail.com CONTRACTOR NAME: C.M. HEATING INC CONTRACTOR ADDRESS: STREET 1415 BROADWAY CITY EVERETT STATE WA ZIP 98201 ' ' ' "'" CONTRACTOR PHONE:425-259-0550 CONTRACTOR EMAIL:KAILANA@CMHEATING.COM CONTRACTOR LIC.#cREQUIREg): CMHEAMH877DN CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 01609s , �,... �... - � _ -.� � .. PRIMARY CONTACT: DOWNER 1]CONTRACTOR ❑ OTHER(Please Specify) ....• CONTACT NAME: CONTACT PHONE:425-259-0550 KA I LANA CONTACT EMAIL:KAILANA@CMHEATING.COM -_ ... 'AGREEMENT:f hereby certify that 1 have read and examined this application and know the same to lie true and correct: All provisions of laws and ordinances governing this ,• ; type of work will be com +lied 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 ,focal law regbiating ns teflon 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/ comply with the ale Co rectors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only PERMIT#: { 12/10/19 E ICI \ 2—&Co Ow err/Authorized Agent Signature\ Date (Revised 1/11/2019) Page 1-ApplicatIon m::