3711 SMITH AVE 2022-05-24 - Laserfiche WebLink

• • ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES .,, 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 I FAX 426-25741 W I(E)everettenetteverettwa.gov) woaweverettwa.govipamate !- " M• ,�''rtro. 'a far f. '4 rt to r 3 n i PROJECT ADDRESS: 3111 51.-1 i N Av E. BUILDING AREA: sq ft PROJECT TYPE: CI NEW CONSTRUCTION 0 ADDITION—S1 TENANT IMPROVfdENT 0 REMODEL BUILDING USE: d SPR 0 TOWNHOUSE 0 DUPLEX 13 ADU 13 MULTI-FAMILY«IA OF UNITS COMMERCIAL liW* .. CONTRACT PRICE OF WORK:$ el t t1u ASSOCIATED BUILDING PERMIT*(if vplicabley DESCRIBE SCOPE OF WORK: aZeptAert., Fate Al R(r NIS INSTALLATION INCLUDES THE FOLLOWING SCOPE:[SELECT ALL THAT APPLY) LINE VOLTAGE WORK? �NO ®YES-Select Stow©Service 13 Feeder 13 Circuits-Si C3 complete Re-wire LOW VOLTAGE WORK? CI NO YES-#of Devices: GO SELECT SCOPE(REQUIRED): 13 Data CI intercom 0 Thermostat 0 maw, 0 Secure Amass CI Security system —11 Eke Alarm-Installations under this permit only include electrical wiring rough-in of the system.An additional Fire Alarm Permit is requited for review of device location and installation approval. Cl Other(List All): IS THIS PERMIT EDUCATION,INSTITUTIONAL HEALTH ANDJOR PERSONAL CARE FACILITIES: NO YES--See Below S Pg.2 By checking this box,I am stating that I neve reed and understand ail of WAC 296-46 ,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: INO OYES-See Below&Pg.3 Pursuant to RCW 19.28.281,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 .,� OWNER NAME: £YErxE C•oSPLL 1+.ISSIQP TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET 3111 ciry STATE: Vn/A zrngi(2.4.7 /OWNER PHONE: OWNER EMAIL: 'CONTRACTOR NAME: S3 0-1 Cl(Lt= CONTRACTOR ADDRESS; STREET Pc ( 3')I f C{rY L 1 N L_T/e.) STATE V.t z 9V2.2.3 -CONTRACTOR PHONE: it2S-. 2-44 I4L s CONTRACTOR EMAIL: Sl:f l 'e B W H F 12ti..(-OWN `CONTRACT"ORUC.##REOUIRE,,D): jSN f l Zi'41J ICITY OF EVERETT BUSINESS ILO tf(REOUIRED): S$ .9-7 PRIMARY CONTACT: 0 OWNER—ISI CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: t}2S 24 Lr /c.f U 7:5 t f 3 yArt� CONTACT EMAIL: Z k F F 6N H F I jtE•Cr-) """ AOREatEle I hereby cattily that I have read and exam this appecaden and,now the somata be true and cornea he prov na of l end onIhw'css govam g this type etwerk he rxmpreted a/bother specified heroin at not. The granting eta ern*does not;magma to give authorityto white or cancel the provisions of any other stare or iacat law regulating constructkn or Ma pe#atsnaeru a of construction, That lath authorized by the aw oo of thts property to p rrn the wont tear which siosecatton is reads and I comply with the Slate Contractors Law 18.27 RCW and 2 200 WAC City of Everett Official Use Only PERMIT#: 'VI) E i o 9 — O S O OwnerrA rized Agent Signature Date 'Atwood inf12O19} Pap 1-Application