2228 CHESTNUT ST 2022-04-04 - Laserfiche WebLink

• ELECTRICAL PERMIT APPLICATION ,� CITY OF EVERETT PERMIT SERVICES h' 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits .', 'PRO;>JECT,S1TE INFORMATION . ° PROJECT ADDRESS: 2228 CHESTNUT ST BUILDING AREA: 920 sq ft PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ADDITION ❑TENANT IMPROVMENT © REMODEL BUILDING USE: ©SFR ❑TOWNHOUSE ❑ DUPLEX ❑ADU ❑MULTI-FAMILY-#OF UNITS:_, ❑ COMMERCIAL ELEC"RCA>a.AP,PLUCAT ON NFORMATION &:D S PTLO OFWOFR C CONTRACT PRICE OF WORK:$ 250 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: ADD CIRCUIT FOR SINGLE ZONE DUCTLESS SYSTEM THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ❑✓ NO ❑YES-Select Scope: ❑ Service ❑ Feeder 0 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'COMPLrIANCE IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: n NO 11 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. t ARE YOU AN OWNER PERFORMING WORK AS THE CONTRACTOR WITHOUT ELECTRICAL LICENSURE: L�INO 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 .06 ,:. . OWNER NAME: KATHLEEN HENNING TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET 2228 CHESTNUT ST CITY EVERETT STATE WA ZIP 98201 OWNER PHONE:425-319-8807 OWNER EMAIL:khenning@gmx.us CONTRACTOR NAME: C.M. HEATING INC CONTRACTOR ADDRESS: STREET 1415 BROADWAY CITY EVERETT STATE WA ZIP 98201 CONTRACTOR PHONE:425-259-0550 CONTRACTOR EMAIL:KAILANA@CMHEATING.COM CONTRACTOR LIC.#1REQUIRED): CMHEAMH877DN CITY OF EVERETT BUSINESS LIC.#(REQUIRED); 016098 PRIMARY •� CONTACT: DOWNER ®CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:425-259-0550 KAf LANA CONTACT EMAIL:KAILANA@CMHEATING.COM AGREEMENT:I hereby certify that t have read and examined this application and know the same to be true and correct.;Ail 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 naguiat g e nstruction'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 c rrrply with th State cremators Law 18.27 RCW and 296,200 WAC, City of Everett Official Use Only / 1 - P PERMIT# 11/13/19 E \ I 0 rlAutho d"Agent rgnature Date '(Revised 1/11,+20191 Page 1-Application