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10719 19TH AVE SE A 2023-04-07
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10719 19TH AVE SE A 2023-04-07
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4/7/2023 10:45:24 AM
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4/7/2023 10:44:56 AM
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Address Document
Street Name
19TH AVE SE
Street Number
10719
Unit
A
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l>• <br /> • <br /> ELECTRICAL PERMIT APPLICATION <br /> EVERETT CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> WASHINGTON (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov i www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: 10719 19th AvenueSE - UnitA IN A : 1,829 ft <br /> DDRESS BUILD IN <br /> REA sq <br /> PROJECT TYPE: NEW CONSTRUCTION ❑ADDITION ❑TENANT IMPROVMENT ❑R�EMUUEL �J <br /> BUILDING USE: ❑SFR ✓❑TOWNHOUSE El DUPLEX ❑ADU ❑MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL <br /> ELECTRICAL APPLICATION INFORMATIONWtNNIMPTJON OF WORK <br /> 1 <br /> CONTRACT PRICE OF WORK:$ 7,893.00 ASSOCIATED BUILDING PERMIT#(if applicable):QJr (1 .0 3-CDESCRIBE SCOPE OF WORK: `J <br /> Wire new Townhouses to code. <br /> THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE:(SELECT ALL THAT APPLY) <br /> LINE VOLTAGE WORK? ❑NO ✓❑YES-Select Scope:❑Service 0 Feeder ❑Circuits-#:24 ❑Complete Re-wire <br /> LOW VOLTAGE WORK? ❑NO ✓❑YES-#of Devices:65 <br /> SELECT SCOPE(REQUIRED): D Data ❑Intercom ❑Thermostat ❑Audio ❑Secure Access ❑Security System <br /> El Fire Alarm-Installations under this permit only include electrical wiring rough-in of the system.An additional <br /> Fire Alarm Permit is required for review of device location and installation approval. <br /> ❑Other(List All): <br /> CODE COMPLIANCE <br /> IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: ©NO ❑YES—See Below&Pg.2 <br /> (� 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 <br /> of this application(see next page),AND Plan Review is NOT required because I meet all of the following sub sections that do not <br /> See Page 2 require Plan Review. <br /> ARE YOU AN OWNER PERFORMING WORK AS THE CONTRACTOR WITHOUT ELECTRICAL LICENSURE: NO DYES-See Below&Pg.3 <br /> — Pursuant to RCW 19.28.261,property owners and leaseholders cannot perform electrical work on buildings for rent,sale,or lease <br /> - without the proper electrical licensing and certification,or exemption.By checking this box,I am stating that I have completed and <br /> See Page 3 signed the AFFIDAVIT on page 3 of this application to receive an exemption from this licensing/certification requirement. <br /> CONTACT INFORMATION <br /> OWNER NAME: AGA Real Estate, LLC TENANT BUSINESS NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 1208 130th Street SE-Unit B <br /> c;TY Everett STATE WA ZIP 98208 <br /> • OWNER PHONE:206-830-0126 OWNER EMAIL:agabuilt@gmail.com <br /> CONTRACTOR NAME: Tughan Electric, Inc. <br /> CONTRACTOR ADDRESS: sraee-r 1911 235th Court NE <br /> CITY Sammamish STATE WA 2,P 98074-4433 <br /> CONTRACTOR PHONE:425-868-8072 CONTRACTOR EMAIL:I-arry@tughanelectric.corn <br /> CONTRACTOR LIC.#(REQUIRED) TUGHAEI943BP JCITY OF EVERETT BUSINESS LIC.#(REQUIRED).044481 <br /> PRIMARY CONTACT: ©OWNER ❑CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:206-830-0126 <br /> Edis Kulaga CONTACT EMAIL:agabuilt@gmail.com <br /> 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 <br /> 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 <br /> local law regulating construction or t 'performance of construction. That I am authorized by the owner of this property to perform the work for which application is made and I <br /> comply with the Stet C tracto a 18.27 RCW and 296.200 WAC City of Everett Official Use Only <br /> PERMIT#: <br /> E <br /> 10/1012019 <br /> OwnerlA homed nt Signature Date (Revised 1/11/2019) Page 1-Application <br />
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