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10721 19TH AVE SE C 2023-04-07
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10721 19TH AVE SE C 2023-04-07
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4/7/2023 11:14:23 AM
Creation date
4/7/2023 11:13:56 AM
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Address Document
Street Name
19TH AVE SE
Street Number
10721
Unit
C
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• <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 f(E)everetteps c©everettwa,gov I www.everettwa.govtpermit8 <br /> PROJECT SITE'INFORIUMN <br /> PROJECT ADDRESS: 10721 19th Avenue SE - Unit C BUILDING 4EA: 1 829 / sq ft <br /> PROJECT TYPE: WI NEW CONSTRUCTION ❑ADDITION El TENANT IMPROVMENT ❑ REML <br /> BUILDING USE: ❑SFR ©TOWNHOUSE El DUPLEX ❑ADU ❑ MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL <br /> ELECTRICAL APPLICATION INFORMATION & DES:.::,:.cIP11ON OF WORK <br /> CONTRACT PRICE OF WORK:$ 7,893.00 ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIBE SCOPE OF WORK: (t) \q4C).2——01k <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 ✓❑Feeder E Circuits-#:24 ❑Complete Re-wire <br /> LOW VOLTAGE WORK? El NO ❑✓ YES-#of Devices:65 <br /> SELECT SCOPE(REQUIRED): ❑ Data ❑ Intercom E Thermostat ❑Audio El 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 /> CO COMPLIANCE <br /> IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: ✓❑ NO DYES—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: ENO EYES-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 /> CONTACTINFORMATION <br /> . ..... ........ ..... ........ ...... ........ <br /> OWNER NAME: AGA Real Estate, LLC TENANT BUSINESS NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 1208 130th Street SE-Unit B <br /> 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: STREET 1911 235th Court NE <br /> CITY Sammamish STATE WA zip 98074-4433 <br /> CONTRACTOR PHONE:425-868-8072 CONTRACTOR EMAIL:Larry@tughanelectric.com <br /> CONTRACTOR LIC.#(REQUIRED):TUGHAEI943BP CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 044481 <br /> PRIMARY CONTACT: ROWNER ECONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:206-830-0126 <br /> E d i s Ku l ag o CONTACT EMAIL:agabuilt@gmail.com <br /> AGREEMENT:t 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 co struction or he 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 S e ontracto Law 18.27 RCW and 296 200 WAC. City of Everett Official Use Only <br /> PERMIT#: <br /> 10/10/2019 EA-Ck <br /> dwner Authorized ent Signature Date (Revised 1/11/2019) Page 1-Application <br />
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