3121 8TH ST A 2022-01-21 - Laserfiche WebLink

• ELECTRICAL PERMIT APPLICATION OF EVERETT CITE00 32 CEDAREVERETT STREET,EVERETTPERMITSERVICES,WA 98201 wns>,rwcrau (P)425-257-8810 I FAX 425-257-8857 i(E)everetteps@everettwa.gov www.everettwa.govipermits a PROJECT I, E FORMATION` PROJECT ADDRESS: 3121 8th St, Everett, WA 98201 IBUlLD1NG AREA: s4 ft PROJECT TYPE: ❑NEW CONSTRUCTION ❑ADDITION 15111 TENANT IMPROVMENT ❑REMODEL BUILDING USE: El SFR ❑TOWNHOUSE Q DUPLEX ❑ADU ❑ MULTI-FAMILY-#OF UNITS:2 C ❑COMMERCIAL ELECT R, APPLICA.TION'INFORMATION & DESCRIPTION OF WORK CONTRACT PRICE OF WORK: \5v C ) (ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF W RK Sewage pump needs to be inspected before it can be turned back on by PUD THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? Z NO ❑ YES-Select Scope: El Service El Feeder El Circuits-#: ❑ Complete Re-wire LOW VOLTAGE WORK? El NO El YES-#of Devices: SELECT SCOPE(REQUIRED): El Data ❑ Intercom El Thermostat El Audio El 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. D Other(List All):Sewage Pump ODE-:COMPLIANCE ,... IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: ✓Q 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, ARE YOU AN OWNER PERFORMING WORK AS THE CONTRACTOR WITHOUT ELECTRICAL LICENSUR fl, O '4YES-See Below&Pg.3 I1 Pursuant to RCW 19.28.261,property owners and leaseholders cannot perform electrical work on .uilding or -nt,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: Joshua Shlemmer TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: srREET 3121 8th St#A c,tv Everett STATE wa ZIP 98201 OWNER PHONE:3604715399 OWNER EMAIL:loshuashlem@gmail.com CONTRACTOR NAME: Owner CONTRACTOR ADDRESS: sTReET3121 8th St#A CITY Everett STATE WA z€P 98201 CONTRACTOR PHONE:3604715399 !CONTRACTOR EMAIL:iOShuashlem{( gmail.com CONTRACTOR LIC.#(REQUIRED):Owner ICITY OF EVERETT BUSINESS LIC.#(REQUIRED):Owner PRIMARY CONTACT: DOWNER ❑CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:3604715399 Josh CONTACT EMAIL:'oshUashlem @gmaiLcam AGREEMENT:I hereby certify that I 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 ern authorized by the owner of this property to perform the work for which application is made and I comply with the State Contractors Law 16,27 RCW and 296.200 WAC. City of Everett Official Use Only PERMIT#: '37//2 65) E Ow lA d Agent Signature Dale (Revised 1/11l2019) Page t•Application