8401 HOLLY DR 2021-12-10 - Laserfiche WebLink

• • ELECTRICAL PERMIT APPLICATION EVERETT CITY OF EVERETT PERMIT SERVICES 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 1 •[ T �1T j,� yyy PROJECT ADDRESS: 8401 Holly Drive BUILDING AREA: sq ft PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ADDITION ✓❑TENANT IMPROVMENT ❑ REMODEL BUILDING USE: J❑ SFR El TOWNHOUSE El DUPLEX ❑ADU ❑ MULTI-FAMILY-#OF UNITS: ✓❑ COMMERCIAL R 4 r4 ?I�1 ► � !L +? •A 101014OR OFWORK CONTRACT PRICE OF WORK:$ 3000 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: 100 amp panel change THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL.THAT APPLY) LINE VOLTAGE WORK? ❑✓ NO ❑YES-Select Scope: ❑ Service ❑ Feeder ❑Circuits-#: ❑ Complete Re-wire LOW VOLTAGE WORK? ❑ NO ❑YES-#of Devices: SELECT SCOPE(REQUIRED): El Data ❑ Intercom ❑Thermostat ❑Audio El Secure Access ❑ Security Syt tern ❑ 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):NIA lfwfli IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: D 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. r ARE YOU AN OWNER PERFORMING WORK AS THE CONTRACTOR WITHOUT ELECTRICAL LICENSURE: L�INO 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. OWNER NAME: Mike Ryan TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET $401 Holly Drive CITY Everett STATE WA ZIP 98208 OWNER PHONE:3607221205 OWNER EMAIL: • CONTRACTOR NAME: Parker Bros Electric CONTRACTOR ADDRESS: sTREET13630 54th Dr NE Marysville STATE WA ZIP 98271 CONTRACTOR PHONE:360-548-3576 CONTRACTOR EMAIL:admin@parkerbroselectrlc.com CONTRACTOR LIC.#(REQUIRED):PARKERBE845NT CITY OF EVERETT BUSINESS LIC.#(REQUIRED):56709 PRIMARY CONTACT: DOWNER ✓❑CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:360-548-3576 Sydney CONTACT EMAIL:Sydney@parkerbroselectric,com AGREEMENT:f 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 of any other state or local law regulating construction or the performance of construction. That I am authorized by the owner of this properly to perform the work for which application is made and! comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only PERMIT#: f/& (a) E2b 031 Owner ut orize gent Signature Date (Revised 1/11/2019) Page 1-Application