10723 19TH AVE SE A 2023-04-07 - Laserfiche WebLink

• • i `! ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES EVERETT 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/permi s PROJECT SITE INFORMATION PROJECT ADDRESS: 10723 19th Avenue SE - Unit A BUILDING REA: 1,829 1 sq ft PROJECT TYPE: lZ/ NEW CONSTRUCTION ❑ADDITION ❑TENANT IMPF:OVMENT ❑ EMODEL BUILDING USE: ❑SFR Z TOWNHOUSE El DUPLEX ❑ADU ❑ MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL ELECTRICAL APPLICATION IwrORMATIO►vrESCR " ON OF WORK CONTRACT PRICE OF WORK:$ 7,893.00 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: L. \�Q o\c<� Wire new Townhouses to code. THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ❑NO ©YES-Select Scope: 21 Service ✓❑ Feeder ❑Circuits-#:24 ❑Complete Re-wire LOW VOLTAGE WORK? ❑ NO ❑✓ YES-#of Devices.65 SELECT SCOPE(REQUIRED): ❑Data ❑ Intercom ❑ Thermostat ❑Audio El 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 All): CODE COMPLIANCE IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: ✓❑NO 1 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: 1NO 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. CONTAC '` NFORMIATION OWNER NAME: AGA Real Estate, LLC TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET 1208 130th Street SE- Unit B CITY Everett STATE WA ZIP 98208 OWNER PHONE:206-830-0126 OWNER EMAIL:agabuilt@gmail.com CONTRACTOR NAME: Tughan Electric, Inc. CONTRACTOR ADDRESS: STREET 1911 235th Court NE CITY Sammamish STATE WA zip 98074-4433 CONTRACTOR PHONE:425-868-8072 CONTRACTOR EMAIL:Larry( tUghaneleCtric.COm CONTRACTOR LIC.*REQUIRED):TUGHAEI943BP CITY OF EV ERETT BUSINESS LIC.#(REQUIRED):044481 PRIMARY CONTACT: DOWNER ❑CONTRACTOR EOTHER(Please Specify) CONTACT NAME: CONTACT PHONE:206-830-0126 Ed i s Ku i ag a CONTACT EMAIL:agabwIt@gmail.com AGREEMENT I hereby certify t al 1 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 wilt 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 I am authorized by the owner of this property to perform the work for which application is made and comply ' he Sta (contractors Law 18.27 RCW and 296.200 WAC City of Everett Official Use Only ,--- V / PERMIT# ,,^� ---- 10/10/2019 E \� �o - Cc)t Owner/ or t Signature Date (Revised 1/11/2019) Page 1-Application