2006 75TH ST SE 2022-03-04 - Laserfiche WebLink

• • ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES A°111111d--." `ill 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 ((E)everetteps@everettwa gov; wv w.everettwa gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 2006 75TH ST SE BUILDING AREA: 1152 sq ft PROJECT TYPE: LI NEW CONSTRUCTION ❑ADDITION ❑TENANT IMPROVMENT ✓❑REMODEL BUILDING USE: ❑✓ SFR ❑TOWNHOUSE ❑DUPLEX ❑ADU ❑MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL 'ELECTRICAL APPLICATION INFORMATION & DESCRIPTION OF WORK CONTRACT PRICE OF WORK:$ 250 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: ADD CIRCUIT FOR SINGLE ZONE DUCTLESS HEAT PUMP INSTALL THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ❑✓ NO ❑YES-Select Scope: ❑Service ❑ Feeder ❑✓ Circuits-#:1 ❑ Complete Re-wire LOW VOLTAGE WORK? ✓❑ NO ❑YES-#of Devices: SELECT SCOPE(REQUIRED): ❑ 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, ❑Other(List All): CODE COMPLIANCE IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: 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. I^ t—t ARE YOU AN OWNER PERFORMING WORK AS THE CONTRACTOR WITHOUT ELECTRICAL LICENSURE: NO ❑VES-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: TOM BANNISTER TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET 2006 75TH ST SE CITY EVERETT STATE WA ZIP 98203 OWNER PHONE:425-760-9386 OWNER EMAIL:thomasbbd@hotmail.com CONTRACTOR NAME: C.M. HEATING INC CONTRACTOR ADDRESS: STREET 1415 BROADWAY air EVERETT STATE WA ZIP 98201 CONTRACTOR PHONE:425-259-0550 CONTRACTOR EMAIL:KAILANA@CMHEATING.COM CONTRACTOR LIC.#{REQUIRED): CMHEAMH877DN CITY OF EVERETT BUSINESS LIC.#REQUIRED): Moss, PRIMARY CONTACT: DOWNER ❑✓CONTRACTOR ['OTHER(Please Specify) CONTACT NAME; CONTACT PHONE:426-259-0550 KA I LAMA CONTACT EMAIL:KAILANA@CMHEATING.COM AGREEMENT:I hereby certify that t have read and examined this application end know the same to be true and correct. All provisions of laws and ordinances governing this 1 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 1 am authorized by the owner of this property to perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only PERMIT l'\//C•i2,4/1/14 7/10/t/idi 11/05/19 E t g I ` 0(00 Owner/Authorized Agent Signature Date (Revised 1/11/2019) Page 1-Application