4935 SEAVIEW WAY 2022-03-02 - Laserfiche WebLink

• mon ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES EVERETT 3200 CEDAR STREET,EVERETT,WA 98201 WASHINGTON tP)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gav www.everettwa.goviperrnIts PROJECT SITE INFORMATION PROJECT ADDRESS:Lig 35 5ecv e‘4,1 1/41:14.A E tv e.t-17,1dP. 113233BUILDING AREA: sq ft PROJECT TYPE: El NEW CONSTRUCTION 0 ADDITION 0 TENANT IMPROVMENT 0 REMODEL BUILDING USE: KSFR El TOWNHOUSE El DUPLEX El ADU LI MULTI-FAMILY-#OF UNITS: C COMMERCIAL ELECTRICAL APPLICATION.INFORMATION Et..PEEMPTION"OF WORK j. CONTRACT PRICE OF WORK:$ ksb ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: lbsitdi Se' r pv ,$)T,K en THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? LI NO 5?..,YES-Select Scope. El Service Feeder LI Circuits-#: 0 Complete Re-wire LOW VOLTAGE WORK? S.NO 0 YES-#of Devices: SELECT SCOPE(REQUIRED): El Data LI Intercom 0 Thermostat E3 Audio 0 Secure Access El Security System 0 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. Ell Other(List All): CODE COMPLIANCE IS THIS PERMIT EDUCATION,INSTITUTIONAL HEALTH AND/OR PERSONAL CARE FACILITIES: n NO E]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 LICENSURESNO EYES-See Below&Pg.3 Pursuant to RCW 19.28.261,property owners and leaseholders cannot perform electrical work on i dings for rent,sale,or lease without the proper electrical licensing and certification,or exemption.By checking this box,I am stating that 1 have completed and See Page 3 signed the AFFIDAVIT on page 3 of this application to receive an exemption from this licensing/certification requirement, •VPATACT,iNFORMATIPINAM,l'-.'i: 0 • ‘‘' OWNER NAME: 54-eve_ Co tCtrn TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET LI Ct-g SfoN c cny 'Eveye+11- STATE V*, ZIP Ci 3 203 OWNER PHONE: 425-2 C,8- SC101 OWNER EMAIL: COYCXVYNS c eamo,it. CONTRACTOR NAME: We ferr cito-y CONTRACTOR ADDRESS: STREET qoqi Hon- e 3 14 A crr( t t;t1h STATE WJ zip g2.2 CONTRACTOR PHONE:SC(7)-1146,-03s q CONTRACTOR EMAIL: Et)Luesi-eirtS•Mo.y crc. CONTRACTOR LIC.#(REQU1RED):Vkl E:57E5441, A.17,VO CITY OF EVERETT BUSINESS LIC.#(REQUIRED): OS Lk 15. 772' • • „•• • , PRIMARY CONTACT: LJOWNER , CONTRACTOR DOTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 3C, oSSI elle v411 g-e It* CONTACT EMAIL: ckcv\ilp Lv,e)44( s fj AN AGREEMENT'I hereby certify that i have reed and examined this application and know the same to he 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. Thai I ant authorized by the owner of this Property to perform the work for which application is made and! comply with the State Contractors Law 18.27 RCW and 298.200 WAC. City of Everett Official Use Only PERMIT#: VIZ/ E cvec..7.00 OwneffAuttToliied Agent — Date (Revised 1/11/2819) Page 1-Application