4111 FEDERAL AVE 2022-06-28 - Laserfiche WebLink

• use ELECTRICAL PERMIT APPLIAION CITY OF EVERETT PERMIT SERVICES EVERETT 3200 CEDAR STREET,EVERETT,WA 98201 WASH INOTON (P)425-257-8810 FAX 425-257-8857 I(E)everetteps@everettwa.gov wwweverettwa.govipermits PROJECT SITE INFORMATION PROJECT ADDRESS: 4111 Federal Ave Everett, Wa 98208 BUILDING AREA: sq ft PROJECT TYPE: 0 NEW CONSTRUCTION El ADDITION El TENANT IMPROVMENT 0 REMODEL BUILDING USE: CI SFR 0 TOWNHOUSE E) DUPLEX El ADU El MULTI-FAMILY.4 OF UNITS: E COMMERCIAL ELECTRICAL APPLICATION INFORMATION & DESCRIPTION OF WORK CONTRACT PRICE OF WORK: $ 3000.00 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: Relocate 200 Amp Service/Panel only. Add 3) circuits in garage. THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? 0 NO 0 YES-Select Scope: 0 Service Li Feeder E Circuits-#: O Complete Re-wire LOW VOLTAGE WORK? 0 NO Li YES-4 of Devices: SELECT SCOPE(REQUIRED): C3 Data El Intercom E Thermostat Audio El Secure Access 0 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. 01Other(List All): CODE COMPLIANCE IS THIS PERMIT EDUCATION, INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: El NO E7 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 l 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: ENO 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 OWNER NAME: Dennis Dempsey TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET 4111 Federal Ave cm, Everett STATE WA zip 98208 OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: Dennis Galli CONTRACTOR ADDRESS: STREET PO Box 2485 crry Lynnwood STATE WA zip 98036 CONTRACTOR PHONE:206.999.7 153 CONTRACTOR EMAIL:CaileleCtriC@BOI.COM CONTRACTOR LIC.4(REQUIRED):CALLE1*1 NON CITY OF EVERETT BUSINESS LIC.#(REQUIRED):59999 PRIMARY CONTACT: DOWNER CONTRACTOR EOTHER(Please Specify) CONTACT NAME: CONTACT PHONE:206,999,;7237 6 3 Dennis Call CONTACT EMAIL:Calleiectric@aacorn AGREEMENT.1 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 wilt 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. Thal I 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#: Dennis Call 11/19/2019 E Owner/Authorized Agent Signature Date (Revised ill 112019) Page I-Application