10719 19TH AVE SE C 2023-04-07 - Laserfiche WebLink

• ELECTRICAL PERMIT APPLICATION EVERETT GiTY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 wasHinrta7orr (ID)425 257-8$10 I FAX 425 257 8857 I(E)everetteps©everettwa.gov www.everettwa.govlpermits PROJECT SITE INFORMATION PROJECT ADDRESS: 10719 19th Avenue SE - Unit C BUILDING AREA: 1,829 sq ft PROJECT TYPE: lr 1 NEW CONSTRUCTION El ADDITION El TENANT IMPROVMENT CI REMODEL BUILDING USE: ❑SFR 7 TOWNHOUSE ❑ DUPLEX CI ADU ❑MULTI-FAMILY-#OF UNITS El COMMERCIAL ELECTRICAL APPLICATION INFORMATION & DESCRIPTION OF WORK CONTRACT PRICE OF WORK:$ 7,893.00 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: C) CI Complete Re-wire Wire new Townhouses to code. THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ❑ NO 71 YES-Select Scope. 7]Service 2) Feeder CI Circuits-#.24 LOW VOLTAGE WORK? ❑ NO ©YES-#of Devices'65 SELECT SCOPE(REQUIRED) ❑ Data ❑ Intercom ❑Thermostat Cl 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. n Other(List All): CODE COMPLIANCE., 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: 7]NO 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 1208 130th Street SE- Unit B OWNER NAME: AGA Real Estate, LLC TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET �/�� p r��7 CITY Everett STATE V VA 98208 �,P 98074-4433 OWNER PHONE:206-830-0126 OWNER EMAIL:agabuilt@gmail.com CONTRACTOR NAME: Tughan Electric, Inc. CONTRACTOR ADDRESS: STREET 1911 235th Court NE cite Sammamish STATE WA CONTRACTOR PHONE:425-868-8072 CONTRACTOR EMAIL:Larryi tughanelectric.eom CONTRACTOR LIC.#(REQUIRED TUGHAEl943BP CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 044481 PRIMARY CONTACT: DOWNER ❑CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:206-830-0126 Edis Kulaga CONTACT EMAIL:agabuilt@gmaii.com AGREEMENT.;hereby certify that l 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 l am authorized by the owner of this property to perform the work for which application is made and l comply with the State..Contractors w 8.27 RCW and 296.200 WAC. City of Everett Official Use Only PERMIT#: �of�a/2o�9 E « to •-o g OwneriAut prized Ag t Signature Date (Revised 1/11/2019) Page 1-Application