8517 7TH AVE SE 2022-07-13 - Laserfiche WebLink

ELECTRICAL PERMIT APPLICATION 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 TES. FORMATIONAz t-*4 PROJECT ADDRESS: 8517 7th Ave SE BUILDING AREA: N/A sq ft PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ADDITION ❑ TENANT IMPROVMENT ✓❑ REMODEL BUILDING USE: E SFR El TOWNHOUSE El DUPLEX ❑ADU ❑ MULTI-FAMILY-#OF UNITS: ✓❑COMMERCIAL ELF AP l.1.<CAI .�.. .�'.. �ATM*, tiEORMAtoIt DESCRIPTION�`�IN ;;:,. 01.. CONTRACT PRICE OF WORK: $ 5200 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: disconnect and reconnect boilers and add washer and dryer circuits THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ❑ NO ❑✓ YES-Select Scope: ❑ Service ❑ Feeder 0 Circuits-#:7 ❑ Complete Re-wire LOW VOLTAGE WORK? 0 NO ❑ YES-#of Devices: SELECT SCOPE(REQUIRED): ❑ Data El Intercom El Thermostat ❑Audio El Secure Access El Security System El 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. E Other(List All): CODE-COMPLIANCE IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: 0 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. ARE YOU AN OWNER PERFORMING WORK AS THE CONTRACTOR WITHOUT ELECTRICAL LICENSURE: ✓❑NO 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. INFORMATION OWNER NAME: St. Mary Magdalen Parrish TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET 8517 7th Ave SE CITY Everett STATE V v`/�/ A ZIP 98208 OWNER PHONE: (425)353-1211 OWNER EMAIL: CONTRACTOR NAME: Milne Electric, Inc. CONTRACTOR ADDRESS: STREET 14582 172nd Dr SE#1 CITY Monroe STATE VVA ZIP 98272 CONTRACTOR PHONE:206-510-8808 CONTRACTOR EMAIL:russ.nichols@milneelectric.com CONTRACTOR LIC.#(REQUIRED):MI NEEi101PN CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 31702 PRIMARY CONTACT: ❑OWNER ['CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:206-510-8808 Russ Nichols CONTACT EMAIL:russ.nichols@milneelectric.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 lam 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#: DmIW signed Ey Pete Sanders Pete Sanders � 5 E_petes d�m�e<t.�wm o MneEe� nd�� E , IagreetotM rta definetl dy the placement of myigwNre on Mt �• 1019.U9.1915'.14:55-0]OQ Owner/Authorized Agent Signature Date (Revised 1/11/2019) Page 1-Application