2520 CEDAR ST 2022-08-11 - 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 PROJECT SITE INFORMATION PROJECT ADDRESS: 2520 Cedar St. BUILDING AREA: 3500 sq ft PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ADDITION ❑✓ TENANT IMPROVMENT El REMODEL BUILDING USE: ❑SFR El TOWNHOUSE El DUPLEX ❑ ADU El MULTI-FAMILY-#OF UNITS: ❑✓ COMMERCIAL ELECTRICAL APPLICATION INFORMATION & DESCRIPTION OF WORK CONTRACT PRICE OF WORK:$ 400.00 ASSOCIATED BUILDING PERMIT#(if applicable): r21 12-02 A DESCRIBE SCOPE OF WORK: Replace existing dishwater 120v 20amp circuit with 240v 30 amp electrical circuit and replace 120v 20amp GFCI circuit with a 120V 15amp circuit to accomodate raceway fill in the existing conduit. THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? El NO ❑✓ YES-Select Scope: ❑ Service El Feeder 0 Circuits-#:2 El Complete Re-wire LOW VOLTAGE WORK? ✓❑ NO ❑YES-#of Devices: SELECT SCOPE(REQUIRED): El Data ❑ Intercom El Thermostat El Audio El Secure Access El 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. El Other(List All): CODE COMPLIANCE IS THIS PERMIT EDUCATION, INSTITUTIONAL, HEALTH AND/OR PERSONAL CARE FACILITIES: 0 NO El 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. CONTACT INFORMATION OWNER NAME: Our Lady of Perpetual Hope TENANT BUSINESS NAME(If Commercial): Interfaith Association of Northwest WA OWNER MAILING ADDRESS: STREET 710 Nineth Ave cn Seattle STATE WA ZIP 98104 OWNER PHONE:425-346-5295 OWNER EMAIL:fdean@interfaithWa.org 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) voluteer work, please contact Ken Christiansen CONTACT NAME: CONTACT PHONE:425-387-3467 Ken Christiansen CONTACT EMAIL:kchristiansen@everettwa.gov 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 constr ti n 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 ntr tors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only PERMIT#: • 12/21/2021 ER` 11 E wner/Authorized Agent Signature Date (Revised 1/11/2019) Page 1-Application