2507 61ST ST SE 2023-06-23 - Laserfiche WebLink

ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES EVERETT 3200 CEDAR STREET,EVERETT,WA 98201 WASH (P)425-257-8810 I FAX 425-257-8857 (E)everetteps@everettwa.gov I www.everettwa.gov/permits pRoise: 1 siTkiwoRmAroti,:„, PROJECT ADDRESS: 2507 61ST ST SE UNIT D BUILDING AREA: so ft PROJECT TYPE: 0 NEW CONSTRUCTION Li ADDITION 0 TENANT livIPROVMENT 0 REMODEL BUILDING USE: E]SFR 0 TOWNHOUSE 0 DUPLEX 0 ADU 0 MULTI-FAMILY-#OF UNITS: El COMMERCIAL ELEpTRIC*.;Atittlf4icAlvtoff,INFoRiviATion &,00-S;RipTi044,0F,:woRK, CONTRACT PRICE OF WORK:$ 1000.00 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: REPLUG AND SWITCH DUE TO DAMAGE FOR FORMER TENANT THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? 0 NO 0 YES-Select Scope:El Service 0 Feeder E Circuits-#:2 0 Complete Re-wire LOW VOLTAGE WORK? E]NO D YES-#of Devices: SELECT SCOPE(REQUIRED): El Data 0 Intercom 71 Thermostat fl Audio El Secure Access El Security System El Fire 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. El Other(List All): CODE COMPLIANCE IS THIS PERMIT EDUCATION, INSTITUTIONAL HEALTH AND/OR PERSONAL CARE FACILITIES: ci 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:ONO OYES-See Below&Pg.3 Pursuant to ROW 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. CPNTAPT:INFPRMATIOtit OWNER NAME: GREG MORRIS TENANT BUSINESS NAME(If Commercial): OWNER'NAILING ADDRESS: STREET 3616 COLBY#729 CITY EVERETT sTATE WA 98201 OWNER PHONE: IOWNER EMAIL: - • - - CONTRACTOR NAME: ROBs ELECTRIC INC CONTRACTOR ADDRESS: sTREET4405 103RD AVE SE (-Ay LAKE STEVENS sTATE WA zip 98258 CONTRACTOR PHONE; CONTRACTOR EMAIL: CONTRACTOR LIC.#(REQUIRED): CITY OF EVERETT BUSINESS LIC.#(REQUIRED):025145 PRIMARY CONTACT: 0OWNER DCONTRACTOR DOTHER(Please Specify) CONTACT NAME: CONTACT PHONE:425 232 3105 ROBE RI CONTACT EMAIL: 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 violete or cancel the previsions of any other state or local law regulating construction or the performance of construction. That am authorized by the owner of this property to perform the work for which application is made and! comply with the State Contractors Law 18.27 RCW and 296.200 WAG. City of Everett Official Use Only 697 PERMIT#: E \006- lop 0 neriAuth Date (Revised 1/11/2019) Page 1-Application