4924 DOGWOOD DR 2022-06-27 - Laserfiche WebLink

Ira ECTRICAL PERMIT APPLI ATION EVERETT CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 WASHINGTON (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 4924 DOGWOOD DRIVE BUILDING AREA: sq ft PROJECT TYPE: ❑ 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:$ 3 /or �yo.�y ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: - REPLACE SERVICE ( ' nra r ''� --� nnii s�I et, ,1 7):, � / P Ej ' '/ 'PAN,' 0P i Ahi. 7 C0 9hr- -C L/ A I T n ED Olt, A 2Q(f Ci{l (i)it -E +w THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THA' j�C'�' —1 LINE VOLTAGE WORK? CI NO 7YES-Select Scope: CI Service ❑ 4C12Z\ 1�Fee I;x.'OoC7 LOW VOLTAGE WORK? CINO ElYES-#of Devices: , J SELECT SCOPE(REQUIRED): El Data ❑ Intercom El Thermostat ❑Au Jl (S S,/-R- ElFire Alarm-Installations under this permit only incluc V Fire Alarm Permit is required for review of device locatior �" c4'c i C(2, fe(WI I (A- ❑ Other(List All): CODE COMPLIANCE ef0 e_ylotv\a€ 1 e e.C+ IS THIS PERMIT EDUCATION, INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FAC , By checking this box, I am stating that I have read and understand all of WAC 2f Wi,"\, L-Q-- . ,_ ,N ('e a F of this application(see next page),AND Plan Review is NOT required because f-�'� � See Page 2 require Plan Review. OC( v %4S c\�e bet r, ARE YOU AN OWNER PERFORMING WORK AS THE CONTRACTOR WITHOUT ELECTRIC 1 Pursuant to RCW 19.28.261, property owners and leaseholders cannot perform E ?CO ( e SSA 8, without the proper electrical licensing and certification,or exemption. By checkin< T ' 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: PAULINE JONSEN-HUNT TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET 33708 37TH PL SW cin, FEDERAL WAY STATE WA ZIP 98023 OWNER PHONE:253.202.1466 OWNER EMAIL: CONTRACTOR NAME: EYLANDER SALES & SERVICE CONTRACTOR ADDRESS: STREET3601 EVERETT AVE cITI EVERETT STATE WA ZIP 98201 CONTRACTOR PHONE:425.259.2161 CONTRACTOR EMAIL:1Ceylarlder@yah00.00m CONTRACTOR LIC.#(REQUIRED):EYLANSS142LP CITY OF EVERETT BUSINESS LIC.#(REQUIRED):016363 PRIMARY CONTACT: DOWNER ['CONTRACTOR ['OTHER(Please Specify) CONTACT NAME: TOO CONTACT PHONE:425.231.2275 JC CONTACT EMAIL:jceylaflder@yahoo.COm AGREEMENT. I hereby certify that I have read and examined this application and know the same to be 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. That I am authorized by the owner of this property to perform the work for which application is made and I comply with t e State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only /, PERMIT#: // / /7 E�� I ! �-��-• I >/f/A____.------ Authorized Agent Signature D to (Revised 1/11/2019) Page 1-Application 1 ,`/