2815 17TH ST 2022-07-13 - Laserfiche WebLink

• • OrErr ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 (P)425-257-8810 I FAX 442b25-2 5 7-8 8 5 7 1(E)everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT ADDRESS: 2815 17th St. BUILDING AREA: 750 sq ft PROJECT TYPE: ❑ NEW CONSTRUCTION El ADDITION ❑TENANT IMPROVMENT 0 REMODEL BUILDING USE: 0 SFR ❑TOWNHOUSE ❑ DUPLEX ❑ADU ❑ MULTI-FAMILY-#OF UNITS: ❑ COMMERCIAL .. � fit L a� I NFORMATION & DESCR1PVION OFINORK CONTRACT PRICE OF WORK:$ 500 ASSOCIATED BUILDING PERMIT#(if applicable): E1902-075 DESCRIBE SCOPE OF WORK: Found damaged drywall and improper wiring when working on ceiling fixtures from previous permit. To watt#olfeterminerextent-of-probfem and?Mmoved old insulation. cing insulation, replaces drywall . THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ❑ NO ❑✓ YES-Select Scope: ❑ Service El Feeder ✓❑Circuits-#:3 ❑ 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): IS THIS PERMIT EDUCATION, INSTITUTIONAL, HEALTH AND/OR PERSONAL CARE FACILITIES: ❑ 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: 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. tea. .,...,.,. .Ct.11+' .,.,. ,,.,o. a.,... : ...,. OWNER NAME: Michael Scott Hanes TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET 2815 17th St. CITY Everett STATE WA ZIP 98201 OWNER PHONE:4252528287 IOWNER EMAIL:hmSWhatslt p@gmail.COr CONTRACTOR NAME: CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: (CONTRACTOR EMAIL: CONTRACTOR LIC.#(REQUIRED) CITY OF EVERETT BUSINESS LIC.#(REQUIRED) PRIMARY CONTACT: DOWNER ❑CONTRACTOR ❑✓OTHER(Please Specify) Mother CONTACT NAME: CONTACT PHONE:2063635600 Pamela Hanes CONTACT EMAIL:hanesps@gmail.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 the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only r PERMIT#: 2Vjr/1 Owner/Author' d Agertt Si nature Date y ( \ (Revised 1/11/2019) Page 1-Application