2218 HOYT AVE B 2021-12-17 - Laserfiche WebLink

EMI 0 LI ELECTRICAL PERMIT APPLICATION EVERETT CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 WAS HIN6TON (P)425-257.8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov l www.everettwa.gov/permits PROJECT SITE INFORMATIO N PROJECT ADDRESS: 2218 Hoyt Ave., Apt. B, Everett, WA 98201 BUILDING AREA: sq ft PROJECT TYPE: ❑NEW CONSTRUCTION ❑ADDITION ❑TENANT IMPROVMENT ❑✓ REMODEL BUILDING USE: ❑SFR ❑TOWNHOUSE d❑ DUPLEX ❑ADU El MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL ELECTRICAL'APPLICATION.INFORMATION & DESCRIPTION OF.WORK CONTRACT PRICE OF WORK:$ 850.00 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: INSTALLATION OF A CIRCUIT TO ACCOMMODATE AN EV CHARGER THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? El NO ❑✓ YES-Select Scope:❑Service 0 Feeder ✓❑Circuits-#: 1 ❑Complete Re-wire LOW VOLTAGE WORK? 0 NO ❑YES-#of Devices: SELECT SCOPE(REQUIRED): ❑Data ❑ Intercom 0 Thermostat ❑Audio ❑Secure Access 0 Security System El Fire Alarm-Installations under this permit only Include electrical wiring rough-in of the system.An additional tFiir�e Alarm Permit is required for review of device location and Installation approval. u Other(List All): CODE COMPLIANCE IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: El NO ❑YES—See Below&Pg.2 (lI By checking this box,I am stating that I have read and understand all of WAC 296-468-900,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 OYES-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 I 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. � CONYACT INFORMATION : .. . . ii OWNER NAME: Christy Lillard TENANT BUSINESS NAME tf Commercial): OWNER MAILING ADDRESS: srae r 2218 Hoyt Ave., Apt. B, crry Everett STATE WA zip 98201 OWNER PHONE: 206-390-4831 OWNER EMAIL: gettat2dbyme@gmail.com CONTRACTOR NAME: Seahurst Electric CONTRACTOR ADDRESS: steEET 2915 Chestnut St. crrr Everett sun WA np 98201 CONTRACTOR PHONE: 425-258-5127 CONTRACTOR EMAIL: dford@seahurst.com CONTRACTOR LIC.#(REQUIRED): SEAHUEID99QN CITY OF EVERETT BUSINESS LIC.#(REQUIRED): I g 7(j: PRIMARY CONTACT: DOWNER ✓❑CONTRACTOR ['OTHER(Please Specify) ,„ CONTACT NAME: CONTACT PHONE: 425-258-5127 Darin Ford CONTACT EMAIL: dford@seahurst.com AGREEMENT::I hereby certify that I have mad and examined this application and know the same to be true and correct. All provisions of laws end ordinances governing this type of work will be completed whether specified herein or not. The granting of a permit does not presume to gAm authority to violate or cancel the provisions of any other state or focal 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 end I camp the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only PERMIT#: ,d „ rg E (\LI 0 , 0 , Owner/Authorized A nt Signet re ate {Revised 1/11/2019) Page 1-AppllcatIon