6004 SEAHURST AVE A 2022-07-27 - Laserfiche WebLink

gim LECTRICAL PERMIT APPLICTION CITY OF EVERETT PERMIT SERVICES EVERETT 3200 CEDAR STREET,EVERETT,WA 98201 WASHINGTON (P)425-257-8810 I FAX 425-257-8857 (E)everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 6004 Seahust -37 BUILDING AREA: sq ft PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ ADDITION ©TENANT IMPROVMENT ❑ REMODEL BUILDING USE: ❑SFR ❑ TOWNHOUSE ❑ DUPLEX ❑ ADU © MULTI-FAMILY-#OF UNITS:2 ❑ COMMERCIAL ELECTRICAL APPLICATION INFORMATION & DESCRIPTION OF WORK CONTRACT PRICE OF WORK:$ 2650 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: Replace 200 AMP Meter Base THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ❑ NO 7 YES-Select Scope: © Service ❑ Feeder ❑ Circuits-#: ❑Complete Re-wire LOW VOLTAGE WORK? ❑ NO El 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): CODE COMPLIANCE IS THIS PERMIT EDUCATION, INSTITUTIONAL, HEALTH AND/OR PERSONAL CARE FACILITIES:5I 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: 0 DYES-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: Austin Kibs TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET 7730 NE 199th St C1n Kenmore STATE WA I,, 98028 OWNER PHONE:425-463-7104 OWNER EMAIL:ack5252@hotmail.com CONTRACTOR NAME: OutToday LLC CONTRACTOR ADDRESS: STREET 14725 NE 20th #D75 CITY Bellevue STATE WA ZIP 980076 CONTRACTOR PHONE:425-615-5000 CONTRACTOR EMAIL:rod@outtoday.com CONTRACTOR LIC.#(REQUIRED): outtol*830j1 CITY OF EVERETT BUSINESS LIC.#(REQUIRED): Applied PRIMARY CONTACT: DOWNER ZCONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:425-615-5000 Rodney CONTACT EMAIL:rod@outtoday.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 co.•- -d 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 regular construe ion 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 e State C• tractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only PERMIT#: .r 'd-3/ E 7_00 3 - 02_Z Ownerf: orized Agent Signature (Revised 1/11/2019) Page 1-Application