709 N BROADWAY 2022-01-11 - Laserfiche WebLink

ELECTRICAL PERMIT APPLICATION E 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 wvnv.everettwa.gov/permits 40/5 PROJECT SITE INFORMATION PROJECT ADDRESS: 709 N Broadway BUILDING AREA: sq ft PROJECT TYPE: ❑NEW CONSTRUCTION ❑ADDITION ✓�TENANT IMPROVMENT El REMODEL BUILDING USE: ❑SFR El TOWNHOUSE El DUPLEX ❑ADU El MULTI-FAMILY-#OF UNITS: COMMERCIAL ELECTRICAL APPLICATION INFORMATION & DESCRIPTION OF WORK CONTRACT PRICE OF WORK:$ 14500.00 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: Power and low voltage to HVAC system controller THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? El NO E YES-Select Scope:❑Service ❑Feeder ❑Circuits-#:1 ❑Complete Re-wire LOW VOLTAGE WORK? ❑NO 0 YES-#of Devices:I SELECT SCOPE(REQUIRED): El Data ❑ Intercom E Thermostat ❑Audio ❑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: E]NO El 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. ARE YOU AN OWNER PERFORMING WORK AS THE CONTRACTOR WITHOUT ELECTRICAL LICENSURE: ONO LIVES-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—'‘ Aiblid OWNER NAME: TENANT BUSINESS NAME(If Commercial):WSDOT OWNER MAILING ADDRESS: STREET P.O. Box 47338 C,T.r Olympia STATE WA ziP 98504 OWNER PHONE:360-705-7000 OWNER EMAIL: CONTRACTOR NAME: Entek Corporation CONTRACTOR ADDRESS: STREETI021 Columbia Blvd crrr Longview Q/() 96 STATE WA Bp 98632 CONTRACTOR PHONE:360-423-3010 CONTRACTOR EmAiLdcox@entekhvac.com CONTRACTOR LIC.#(REQUIRED):ENTEKC*B93WE CITY OF EVERETT BUSINESS LIC.#(REQUIRED):57871 PRIMARY CONTACT: UOWNER ✓[CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:360-423-3010 Jennifer Cox CONTACT EMAIL:jcOx@entekhVaC,COM AGREEMENT.1 hereby certify that t have read and examined this application and know the same to be two and correct. All provisions of laws and ordinances governing this type of work wr` 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 stale or local law reg alit g construction or the performance of construction. That!am authorized by the owner of this property to perform the work for which application is made and/ comply wittithe tale Contractors Law 18,27 RCW and 296.200 WAC. City of Everett Official Use Only PERMIT#: E \C' Dn1 ?-12) Owner/A ithoriz gen gnature Date (Revised 1/11/2019) Page 1-Application 1