6601 BEVERLY BLVD 2022-01-24 - Laserfiche WebLink

• 0 IIM `: ELECTRICAL PERMIT APPLICATION EVERETT 32CITY OF EVERETT PERMIT SERVICES 00 CEDAR STREET,EVERETT,WA 98201 WASHINGTON (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I wr,w.everettwa.govlpermils PROJECT SITE INFORMATION • PROJECT ADDRESS: 6601 Beverly Blvd Everett 98203 BUILDING AREA: sq ft PROJECT TYPE: Cl NEW CONSTRUCTION ❑ADDITION ❑TENANT IMPROVMENT CI REMODEL BUILDING USE: 0 SFR ❑TOWNHOUSE El DUPLEX ❑ADU ❑MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL ELECTRICAL APPLICATION INFORMATION&DESCRIPTION'OF WORK' A ,,, .,_ CONTRACT PRICE OF WORK:$ 10000 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: Whole Home Rewire-approx. 1900 sqft THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE:(SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ❑NO YES-Select Scope:❑Service ❑Feeder 0 Circuits-#: 0 Complete Re-wire LOW VOLTAGE WORK? ❑✓ NO Cl YES-#of Devices: SELECT SCOPE(REQUIRED): El Data LI Intercom ❑Thermostat El 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. El Other(List All): CODE COMPLIANCE IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: CI NO El YES—See Below&Pg.2 i l 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: 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. CONTACT INFORMATION OWNER NAME:Jim Hoagland TENANT BUSINESS NAME{if Commercial): OWNER MAILING ADDRESS: sraeET 6601 Beverly BLVD cr,,. Everett STATE wa zm 98203 OWNER PHONE:na OWNER EMAIL:na CONTRACTOR NAME: in House Electric CONTRACTOR ADDRESS: STREET 1530 117th DR SE crrr Lake Stevens STATE WA Z,p 98258 CONTRACTOR PHONE:4257603203 CONTRACTOR EMAIL:ihepermits gmail.com _CONTRACTOR LIC.#(REQUIRED):inhoueS952gg CITY OF EVERETT BUSINESS LIC.#(REQUIRED):04416 PRIMARY CONTACT: DOWNER D✓CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:4257603203 Kelsey CONTACT EMAIL:kelsey@inhOUSeeleCtriC.COm 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 . ..metaled w • •er specified•: +in 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 tar Waling .nstruction. the perform, : .f constructi.n. That I em authorized by the owner of this property to perform the work for which applicaiion is made and I comply with the St:to Contrac•rs Law 18,27 ' :nd 296. el AC. City of Everett Official Use Only * /1 1 ‘97 /( PERMiE I # v (o- 162 Owner/A orized Agent Signature - rate (Revised 1/f 1/2019) Page 1-Application Scanned with CamScanner