1721 70TH PL SE 2023-06-14 - Laserfiche WebLink

ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-25LMID I FAX 425-257-84157 1(E) everedepe@everehwa9w l Wes, 111redwa 911/ParmBs PROJECT SITE INFORMATION PROJECT ADDRESS: 172170TH PL SE EVERETT WA 98203 BUILDING AREA: aqN PROJECT TYPE: ❑ NEW CONSTRUCTION ® ADDITION ❑ TENANT IMPROVMENT ❑ REMODEL BUILOINGUSE: ®SFR ❑TOWNHOUSE ❑DUPLEX El ADD ❑MULTI-FAMILY-p OF UNITS'. ❑COMMERCIAL ELECTRICAL APPLICATION INFORMATION A DESCRIPTION OF WORK CONTRACT PRICE OF WORK: S 898.M ASSOCIATED BUILDING PERMIT#IT applicable): DESCRIBE SCOPE OF WORK: WSOARROOFMOONT THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? (ENO ❑ YES - Soled Scapa: ❑ Service ❑ Feeder ❑ Circull ❑ Compiled Rewire LOW VOLTAGE WORK? ONO O'YES-gof DBVloes:301RCUDS SELECT SCOPE (REQUIRED) 0 No ❑ IMersom ❑ Thermostat ❑ Audio ❑ Secure Access ❑ Secudy System ❑ Fire All - Installa4ms under this permit mly include Electoral wiling rough -in aMe system. An atltlXional Fire Alarm Permit is required for review of device location and Instelleebn approval. ❑ Other (List All)'. CODE COMPLIANCE IS THIS PERMIT EDUCATION,INSTITUTIONAL, HEALTH ANDIOR PERSONAL CARE FACILITIES: KNO YES — See Below PPg.2 ❑ By checking this box, I am staling Met I have read and understand all M WAO 296d613.900, selected tM1e specific reason an page 2 of this application (sea next page), AND Plan Review is NOT required because I meet all of Me following sub sections that do rot See Page require Plan Review. ARE YOU AN OWNER PERFORMING WORK AS THE CONTRACTOR WITHOUT ELECTRICAL UCENSURE: NO YES -See Below l Pg.3 ❑ Pursuant to FR W 19,28.261, property owners and leaseholders cannot perform electrical work on buildings for rent, sale, or lease without the proper ele tread licensing and certification, or exemption. By checking this box, I am stating that I haw completed and Sea Page signed the AFFIDAVIT On pipe 30 this application to recei an exemption from this li0ensing1cerlifi0ation requirement. CONTACT INFORMATION OWNERNAME: RUSSELLWmSON TENANT BUSINESS NAME (if Commercial): OWNER MAILING ADDRESS STREET 172170TH PL SE OTe EVERETT R WA the grarm OWNER PHONE: 425119 OWNER EMAIL:O""syaal�gmeaeve CONTRACTOR NAME: SFI EN POWER CONTRACTOR ADDRESS: STREET 5716 BEDFORD STREET PANDO Ul WA ZIP Will CONTRACTOR PHONE: 50B' CONTRACTOR EMAIL PE STING PWSOLCEN Peen OM CONTRACTOR LIGMREOVIREOg SOLGERUVOIE CITY OF EVERETT BUSINESS LIC.YREQVIREOg 02Yat PRIMARYCONTACT: EOWNER KCONTRACTOR OOTHER(Please Specify) CONTACT NAME: NICOLE RELYEA CONTACT PHONE: SW an a" CONTACT EMAIL: PFfdA1rTNO Weg remo ENHOWER COM AbffLLVLNf nereoY mM mx mere rceo au exammo mo gparemm erw xnow me genre m w 1me ova mma..w p"wmnc a lmra uu warenwe pavmup mn bee olwM uvtlMwrya'ehd wrgme. apat'YieEreren w"d lrre pe"tvq NepmlA does mrpnwvlaropeewMbrovkNlewu"celmepmHa.ma orenrolMraferew b[anyvalh the Caro rmo Few182wnwlI29620)W.TMr1em.IYMlmo4vmeomwWmle a'WaMrooa'Ioml me awklf Ever gyp eNiUre only of compNwlm mo Stele Cmfreclors 1aw16.2]RCWeM 296.2re WAS. CI of EvereROMckI Use One PERMIT p: AcAsjual Altai 10.11-2mt I E OwnanAuthodced All Sion m Date (Reerree VVISVIR Pepe tipplkatlan