3010 51ST PL SW 2023-06-08 - Laserfiche WebLink

ELECTRICAL PERMIT APPLICATION E VE R E T T CITY OFEVERER PERMIT SERVICES 32W CEDAR STREET, EVEPETT, WAll WASKINGrON IPI42S257A810I FAX02S257-8857 (E)eVarenepe0everemw.9ovi 1'x'xxaverelMa.9avfW^nik PROJECT SITE INFORMATION PROJECT ADDREss: 3010 51 st PL SW IBUILDING AREA: =5 q s PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ADOMON ❑TENANTIMPROVMENT ©REMODEL WILDINGUSE: 12SFR ❑TOWNHOUSE ❑DUPLEX ❑ADU ❑MULTI-FAMILY-p OF UNITS._ ❑COMMERCIAL ELECT k APPW ON INFORMATION & DESCRIPTION OF WORK '- CONTRACTPRICEOFWO :g \Sc7 ASSOCIATED BUILDING PERMIT#(if eppltcable): DESCRIBE SCOPE OF K:-...._---_,._--e Re -run 5 shouts from pagraill due to kitchen appliance replacement, replace aluminum wire with grounded Copper wire, add new circut for range exhaust fan, and add receptical for one kitchen circut. THIS INSTALLATION INCLUDES THE FOU.OMNG SCOPE: ISELECT ALL THAT APPLY) LINE VOLTAGE WORK? ❑ NO 0 YES-SaleU S ❑ 9eMce ❑ Feeder [PI CIrsoM .5 ❑ Compete R"m LOW VOLTAGE WORK? ❑ NO ❑ YES 8 of Devices: SELECT SCOPE (REQUIRED) 0 Data ❑ Inlercam ❑ Thmmoatst ❑ Audio ❑ Secure Acceee ❑ Security System ❑ Flre Mom - Inatallalbna under Nis permit only Include alecldcal wiring rough -In tithe system. An WhAllonal Flat Atom Transit Is repaired far review ddevice Iocallon and Instal appreval. ❑ ONer(UMAIU: CODE COMPLIANCE IS THIS PERMIT EDUCATKIN, INB1RUaONAL HEALTH AND/OR PERSONAL CARE FACILrNEs: ✓NO VES—Sae Below&Pit ❑ By chasoNN Nls box.I am eM" Nat l have read and understand all of WAC 2 4611-900, selected the specific reason on page dthis application (seas mot page), AND Plan Review N NOT required because I meet all of Ne following sub sections Nat do not See Paget require Plan Review. ARE YOU AN OWNER PERFORMNG WORK AS THE CONTRACTOR WITHOUT ELECTRICAL LICENSURE: NO ✓YES -See Bebw&Pg.3 Pursuentto RCW 19.28.nl, property owmrers and leaseholders modemst perform elections! ma: on bu9dnge for rent, safe, "Jesse Without Me proper Aechical licensing and cedi0cagon, orexempllon. Bycherkbg thN has. Jam strang that I Mve completed no ee Po9e8 signed the MFIDAVT an page 3 of Nis appltcalionlowcaiveanemmpton mMnliceneingfmdmmuonrequim et. CONTACT INFORMATION -- OWNERNAME:.IaCobClOse TENANT BUSINESS NAME (if Commercial: OWNER MAKING AOOREain amaT 301051STPLSW ,x,,. EVEIMU 5TAmWA ae98203 OWNER PHONE:206-719-0399 OWNER EMAIL:fnCI09e@gmal1.wrn CONTRACTOR NAME; CONTRACTOR ADDRESS: Sasser cam Mee CONTRACTORPHONE:N/A CONTRACTOREMAILA/A CONTRACTOR LIC.N(REQUIRED)MA, CITY OF EVERETT BUSINESS UC. N(REQUIRED)p N/A PRIMARYCONTACT: RIOWNER OCCINTRACTOR QOTHER(Please Specify) CONTACT NALIE: Jacob CIOse CONTACTPHUNE:20O-719-0399 CONTACTEMML:IncloseQggmail.wm E 2et O- 00cA