505 E VIEW RIDGE DR 2025-10-24 - Laserfiche WebLink

iu7 �ECTRICAL PERMIT APPLII_: XION CITY OF EVERETT PERMIT SERVICES E V E R. E T T 3200 CEDAR STREET, EVERETT, WA 98201 WASHINGTON (P) 425-257-8810 1 FAX 425-257-8857 1 (E) everetteps@everettwa.gov I www.everettwa.gov/peimits z�r'-ff r 'L# y{ i'k "-'B:S `1�� .$ ■■ #111^'Aa%sXe hrR l`+,�'A p'33gr k'0. 4 5`1s ,y' tf •,`+s, ".'_ x 'c 'Y .� d 7 & � tS 's.. ` g 5.},`,", r[i...' . .... J� :wi. ,.- PROJECT ADDRESS: �- ( 1R� (IjC BUILDING AREA: sq ft PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ ADDITION ❑ TENANT IMPROVMENT REMODEL BUILDING USE: ❑ SFR ❑ TOWNHOUSE ❑ DUPLEX ❑ ADU ❑ MULTI -FAMILY - # OF UNITS: ❑ COMMERCIAL :' s ELEC'F1iC1 "PLiCTIQ_.itl11t._1TNFW. CONTRACT PRICE OF WORK: $ 2 °I D ASSOCIATED BUILDING PERMIT # (if applicable): . DESCRIBE SCOPE OF WORK: C;`R!C L " DC J4,FA7, S 5 %-W. THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ❑ NO ❑ YES - Select Scope: ❑ Service ❑ Feeder Circuits-#:_'4_ ❑ 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 A] 1): IS THIS PERMIT EDUCATION, INSTITUTIONAL, HEALTH AND/OR PERSONAL CARE FACILITIES: R1 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: WNO EIYES -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 one page of this application to receive an exemption from this licensing/certification requirement. {3 F.n,57�sl!J. frya�,+� . r^''�T sy',,\f�T"i �M L✓ `u 8 1t; 4C'}'� 1. „T. ...«_, ,. N _,_...,.,,. OWNER NAME: *iS TENANT BUSINESS NAME (If Commercial): OWNER MAILING ADDRESS: STREET 50 ^= !n E CITY STATE ij zip q _, 2, OWNER PHONE: SI . OWNER EMAIL: CONTRACTORNAME: -EDT<T'S-rDL..)=C'TRIC_ CONTRACTOR ADDRESS: STREET Pp3 CITY STATE LU-A zIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LIC. #(REQUIRED): ICITY OF EVERETT BUSINESS LIC. #(REQUIRED): PRIMARY CONTACT: 49eWNER CONTRACTOR ❑OTHER (Please Specify) CONTACT NAME: Do CONTACT PHONE: OP cl,2s^_ ge, Y— ZZO L CONTACT EMAIL: 1 /Ut=B AGREEMENT.• I hereby certify that I have read and examined this appucauon and Know me same ro be rrue and correci. Hn provisions ur iaws and uramaduas yuvrmrny uns type of work will be completed whether specked 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 Cont or aw 18.27 RCW and 296.200 WAC. City of Everett Official Use Only PERMIT #: - _zLi-z I E . 25o2 - 2 T� Owner/J uth d Age Ignature Date (Revised 111112019) Page 1 Application