6119 COMMERCIAL AVE 2021-12-16 - Laserfiche WebLink

• • is ELECTRICAL PERMIT APPLICATION EVERETT CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 Wt.SHINGTON (P)425.257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.govI www.everettwa.gov/permits PROJECT SITE,INFORMATION PROJECT ADDRESS: 6119 Commercial AVE Everett 98203 BUILDING AREA: sq ft PROJECT TYPE: ❑NEW CONSTRUCTION El ADDITION El TENANT IMPROVMENT REMODEL BUILDING USE: D SFR El TOWNHOUSE El DUPLEX ❑ADU ❑MULTI-FAMILY-#OF UNITS: El COMMERCIAL ELECTRICAL APPLICATION INFORMATION & DESCRIPTION OF WORK CONTRACT PRICE OF WORK:$ 1200 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: 20 amp dishwasher circuit 20 amp circuit for 3 outlets THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE:(SELECT ALL THAT APPLY) LINE VOLTAGE WORK? El NO 7 YES-Select Scope:E Service ❑Feeder Circuits-#:2 CIComplete Re-wire LOW VOLTAGE WORK? E NO ❑YES-#of Devices: SELECT SCOPE(REQUIRED): ❑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. ❑Other(List All): CODE COMPLIANCE IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: El 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 ail 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 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. C_ONTACTAtitORMMMATION . OWNER NAME: Heather Shaw TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET 6119 Commercial Ave cm Everett STATE WA zie 98203 OWNER PHONE:na [OWNER EMAIL:na CONTRACTOR NAME: In House Electric CONTRACTOR ADDRESS: smEET1530 117th DR SE cm Lake Stevens STATE WA na 98258 CONTRACTOR PHONE:4257603203 CONTRACTOR EMAIL:kelSey@inhouseeleCtriC.COm CONTRACTOR LIC.#(REQUIRED):inhoues952gg CITY OF EVERETT BUSINESS LIC.#(REQUIRED):044168 PRIMARY CONTACT: DOWNER ❑CONTRACTOR DOTHER(Please Specify) CONTACT NAME: CONTACT PHONE:4253209149 kelsey CONTACT EMAIL;kelsey@4 inhouseelectriC.corrl AGREEMENT:I hereby certify that 1 have read end 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 property to perform the work for which application is made and 1 compl>�the_State Contractors Law 18.27 RCW end 296.200 WAC. City of Everett Official Use Only PERMIT#: 00.3/ram E lot Q - Owner/ uthorized Ag tgnature Date (Revised 1/11/2019) Page 1-Application Scanned with CamScanner