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• . <br /> ni ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> EVERETT 3200 CEDAR STREET,EVERETT.WA 98201 <br /> WASHINGTON (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwagov I www.everettwagovipermits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: 10725 19th Avenue SE - Unit C BUILDINte AREA: 1,829 <br /> sq ft <br /> PROJECT TYPE: Z NEW CONSTRUCTION El ADDITION El TENANT IMPROVMENT II REMODEL <br /> BUILDING USE: El SFR 7 TOWNHOUSE El DUPLEX E ADU Li MULTI-FAMILY-#OF UNITS: r7 COMMERCIAL <br /> ELECTRICAL APPLICATION INFORMATION & DESCRIPITWOF WORK <br /> CONTRACT PRICE OF WORK:$ 7,893.00 ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIBE SCOPE OF WORK: <br /> Wire new Townhouses to code. Q_1 (Z0r3 -CI r- . <br /> THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) <br /> LINE VOLTAGE WORK? El NO El YES-Select Scope:El Service 171 Feeder 1:1 Circuits-#:24 CI Complete Re-wire <br /> LOW VOLTAGE WORK? 0 NO [:::YES-#of Devices:65 <br /> SELECT SCOPE(REQUIRED). E Data E Intercom El Thermostat El Audio El Secure Access El Security System <br /> E] 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 /> El Other(List All): <br /> CODE COMPLIANCE <br /> IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: 7 NO CI 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: Z NO EYES-See Below&Pg. 3 <br /> Pursuant to RCVV 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 /> CONTAINFORMAIION <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:2 06-830-0126 OWNER EMAIL:agabuilt@grnail.com <br /> .._........„:„........., _ ..— . ..._,...„,„.. . .„.... .. ..—..3,,,,, <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@tUghaneleetriC.COM <br /> CONTRACTOR LIC.#(REQUIRED):TUGHAE1943BP CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 044481 <br /> ...,.,..,....,,..,. ...,...........,, <br /> PRIMARY CONTACT: DOWNER ECONTRACTOR ElOTHER(Please Specify) _ <br /> CONTACT NAME: CONTACT PHONE:206-830-0126 <br /> Ed IS Ku I aga 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 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 <br /> co ' the tate;Coptract Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only <br /> PERMIT#: <br /> „(____ <br /> E vc7k0 _ o(v <br /> 10/10/2019 <br /> Owner/Authorize gent Signature Date (Revised 1/11/2019) Page 1-Application <br />