Laserfiche WebLink
ELECTRICAL PERMIT APPLICATION <br /> / 4 _ CITY OF EVERETT PERMIT SERVICES <br /> I� a 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 FAX 425-257-8857 (E)everetteps@everettwa.gov www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: 2405 Maple St BUILDING AREA: sq ft _ <br /> PROJECT TYPE: ❑ NEW CONSTRIJCTION ❑ADDITION ❑TENANT IMPROVMENT ❑ REMODEL <br /> BUILDING USE: Li SFR ❑TOWNHOUSE ❑ DUPLEX ❑ADU ❑ MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL <br /> ELECTRICAL APPLICATION INFORMATION & DESCRIPTION OF WORK <br /> CONTRACT PRICE OF WORK:$2000 ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIBE SCOPE OF WORK: <br /> 100a panel change <br /> THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) <br /> LINE VOLTAGE WORK? ❑ NO ®YES-Select Scope: ❑Service ❑ Feeder ❑Circuits-#: El Complete Re-wire <br /> LOW VOLTAGE WORK? RI NO ❑YES-#of Devices: <br /> SELECT SCOPE(REQUIRED): El Data ❑ Intercom El Thermostat ❑Audio El Secure Access ❑Security System <br /> ❑ 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: El NO DYES--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: ONO EYES-See Below&Pg.3 <br /> Pursuant to RCW 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 /> CONTACT"'NFORMATION <br /> OWNER NAME:AUStin Mckeehan TENANT BUSINESS NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET2405 Maple St <br /> CI-PrEverett STATE •`A Z,P98201 <br /> OWNER PHONE: 425-870-2818 OWNER EMAIL: austinkenneth@gmail.com <br /> CONTRACTOR NAME: Switch Electric <br /> CONTRACTOR ADDRESS: STREET 7226 139th Ave NE <br /> Lake Stevens STATE WA ZIP 98258 <br /> CITYCONTRACTOR PHONE:425-244-5511 CONTRACTOR EMAIL:service@mySWltChelectric.COm <br /> CONTRACTOR LIC.#(REQUIRED):SWI I(.hL91 F'K CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 052557 <br /> PRIMARY CONTACT: DOWNER ✓❑CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:253-376-7662 <br /> Tiffany Erickson <br /> CONTACT EMAIL:tiffany@myswitchelectric.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 /> comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only <br /> PERMIT#: ( <br /> �.,— 4/19/19 E `"A O t"k \ ( C) <br /> Owner/Authorized Agent Signature Date (Revised 1/11/2019) Page 1-Application <br />