3419 NORTON AVE 2022-02-15 - Laserfiche WebLink

I • ELECTRICAL PERMIT APPLICATION EVERETT CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 WASNINGTcN (P)425-257.8810 I FAX 425-25743857 I(E)everetteps@everettwa.gov I www,everettwa.gov/permits M,. ..., " :PROJECT SI' E INFORMATJON x; ,. ns - ;. PROJECT ADDRESS: 3419 Norton Ave Everett 98201 BUILDING AREA:Norton sq ft PROJECT TYPE: ❑NEW CONSTRUCTION 4DITION ❑TENANT IMPROVMENT d REMODEL BUILDING USE: El SFR ❑T C1&JPLEX ❑ADU ❑MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL ELE il►L APPLICATION INFORMATION&DESCRIPTION OF WORK CONTRACT PRICE OF WORK:‘ 5 Ci ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: 20 amp small appliance circuitfor`[sland THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE:(SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ❑NO ❑✓ YES-Select Scope:❑Service ❑Feeder El Circuits-#:1 ❑Complete Re-wire LOW VOLTAGE WORK? ❑NO ❑YES-#of Devices: SELECT SCOPE(REQUIRED):0 Data ❑Intercom ❑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. CI Other(Ust NI): IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: Ki 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 followin.sub sections that do not See Page 2 require Plan Review. ARE YOU AN OWNER PERFORMING WORK AS THE CONTRACTOR WITHOUT ELECTRICAL LICENSURE: ' O OYES-See Below&Pg.3 oPursuant to RCW 19.28.261,property owners and leaseholders cannot perform electrical work on b Pdings 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. CO TACT INFfaI +fATION _ q OWNER NAME:Kate Haagen TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: sTRaET 3419 Norton AVE cm Everett STATE WA ZIP 98201 OWNER PHONE:na OWNER EMAIL:na CONTRACTOR NAME: In House Electrical Services, Inc. CONTRACTOR ADDRESS: sTREET1530 117th DR SE CM Lake Stevens STATE WA zip 98258 CONTRACTOR PHONE:4253209149 _CONTRACTOR EMAIL:kelsey@inhouseelectric.com CONTRACTOR LIC.#(REQUIREDI:inhaues952gg CITY OF EVERETT BUSINESS LIC.#(REQUIRED):044168 PRIMARY CONTACT: DOWNER ❑CONTRACTOR ['OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:4253209149 teisey 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 convect. Alt provisions of laws and ordinances governing this type of work will be completed whether specific• 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 focal law •r ' •construct'. • the patio" of construction. That I am authorized by the owner of this property to perform the work for which application is made and I comply the 'tate Contra.,•rs Law 1:if' 298.200 WAC. City of Everett Official Use Only PERMIT#: A At A E �,°,o� - l� Owner/ rIzedA" Signif"f Date (Revised 1/11/2019) Page 1-ApplIcation Scanned with CamScanner