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

L„ ELECTRICAL PERMIT APPLICATION E V E IN E T T CITY OF EVERETT PERMIT SERVICES • 3200 CEDAR STREET.EVERETT,WA 98201 WASHINt�TON (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps@everettwa.gov i www.everettwa.gov/permits III PROJECT`SITE INFORMATION _ PROJECT ADDRESS: 10723 19th Avenue SE - Unit C BUILDIN AREA: 1,829 ) sq ft PROJECT TYPE: I� NEW CONSTRUCTION El ADDITION ❑TENANT IMPROVMENT ❑REMODEL BUILDING USE: ❑SFR 0 TOWNHOUSE ❑ DUPLEX El ADU ❑ MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL ELECTRICAL APPLICATION INFORMATION & DESCRIPTIONOF 'ORK CONTRACT PRICE OF WORK:$ 7,893.00 ASSOCIATED BUILDING PERMIT#Of applicable): DESCRIBE SCOPE OF WORK: � '� —C�.� Wire new Townhouses to Code. THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? El NO 0 YES-Select Scope: ✓❑Service ©Feeder ❑Circuit s-# 24 ❑Complete Re-wire LOW VOLTAGE WORK? ❑NO YES-#of Devices:65 SELECT SCOPE(REQUIRED) ❑Data ❑ Intercom ❑Thermostat El Audio ❑Secure Access ❑ Security System r ElFire 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 Alf): 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: ©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 OWNER NAME: AGA Real Estate, LLC TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET 1208 130th Street SE-Unit B �, , Everett STATE WA ,,P 98208 OWNER PHONE:206-830-0126 OWNER EMAIL:agabuiit@gmail.cam 1911 235th Court NE CONTRACTOR NAME: Tughan Electric, Inc. CONTRACTOR ADDRESS: STREET art Sammamish STATE WA zlp 9$074-4433 CONTRACTOR PHONE:425'$6$-$072 CONTRACTOR EMAIL:Larry@tughanelectric.com CONTRACTOR LIC.#(REQUIRED):TUGHAEI943BP CITY OF EVERETT BUSINESS LIC.#iREQUIRED): 044481 PRIMARY CONTACT: ❑✓OWNER ❑CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:206-$30-0126 E d i s Ku l aga CONTACT EMAIL:agabuilt@gmail.com ,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 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 I am authorized by the owner of this property to perform the work for which application is made and I corn ' he _,.Contractr 'taw 18.27 RCW and 296.200 WAC. City of Everett Official Use Only PERMIT# i 10/10/2019 E Vc\ 0 �o3. OwnerlAuct orize gent Signature Date (Revised 1/11/2019) Page 1-Application