3002 16TH ST B 2023-06-13 - Laserfiche WebLink

ll� giECTRICAL PERMIT APPLIORTIOII� CITY OF EVERETT PERMIT SERVICES `C' 20 q MAY L J) EVERETT 3200 CEDAR STREET,EVERETT,WA 98201 'CyY! f LU2� wnstnuaToN (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everetiwa.gov I www.everettwa.gov/pe tmitsx PROJECT SITE INFORMATION ` (, ..J�k 1)N:KS PROJECT ADDRESS: 3002 16th st Everett WA 98201 BUILDING AREA: 960 sq ft PROJECT TYPE: iI NEW CONSTRUCTION ❑ADDITION ❑ TENANT IMPROVMENT El REMODEL BUILDING USE: ❑SFR El TOWNHOUSE El DUPLEX CI ADU ❑ MULTI-FAMILY-#OF UNITS: ❑ COMMERCIAL ELECTRICAL APPLICATION INFORMATION & DESCRIPTION OF WORK CONTRACT PRICE OF WORK: $ 8000.00 ASSOCIATED BUILDING PERMIT#(if applicable): C-1806-002 DESCRIBE SCOPE OF WORK: 20x24 garage with adu. Run power from house main service to new structure. Install double meter. Rough in garage and adu for standard lighting, outlets, electric hot water heater. (no washer/dryer) base board heat. Outside lighting, bathroom fan, kitchen stove /fan. 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 E YES-#of Devices: smoke detectors SELECT SCOPE(REQUIRED): ❑Data ❑Intercom El Thermostat ❑Audio El 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 All): CODE COMPLIANCE IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: ❑✓ NO El YES--See Below&Pg.2 I 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: ❑NO 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. CONTACT,'INFORMATION OWNER NAME: Terrence Murray TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET 3002 16th St �m Everett STATE WA ZIP 98201 OWNER PHONE: OWNER EMAIL:terry98272@yahoo.com CONTRACTOR NAME: N/A CONTRACTOR ADDRESS: STREET crry STATE ZJP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LIC,#(REQUIRED): CITY OF EVERETT BUSINESS LIC.#(REQUIRED): PRIMARY CONTACT: ❑✓OWNER ❑CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:425 780 2937 Terrence Murray CONTACT EMAIL:terry98272@yahoo,com AGREEMENT:t hereby certify that I have read and examined this application and know(he 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 comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only PERMIT#: