216 MADISON ST 2023-07-13 - Laserfiche WebLink

EVERETT 3200 CEDAR STREET,EVERETT,WA 98201 WASHINGTON (P)425-257-8810 1(E)PemlitServiceseeverettwa.gov I www.evereriwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS 216 Madison St Everett WA 98203 BUILDING AREA: 1545 sq ft PROJECT TYPE: ✓❑ NEW CONSTRUCTION ❑ADDITION []TENANT IMPROVMENT ❑REMODEL BUILDING USE: ❑✓ SFR ❑TOWNHOUSE ❑DUPLEX ❑ADU ❑MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL ELECTRICAL APPLICATION INFORMATION & DESCRIPTION OF WORK CONTRACT PRICE OF WORK:;16,790 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK:Solar array- rooftop installations Solar array- rooftop installations THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) UNE VOLTAGE WORK? ❑NO AYES-Select Scope: ✓❑Service ❑Feeder ❑Circuits-# []Complete Rewire LOW VOLTAGE WORK? El NO ❑YES-#of Devices: SELECT SCOPE(REQUIRED): ❑Data ❑Intercom ❑Thermostat ❑Audio ❑Secure Access ❑Security System ❑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. ❑Other(List All): CODE CONPL.IANCE IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: ✓ NO U YES—See Below&Pg. 2 ❑ By checking this box,I am stating that I have read and understand all of WAC 29646B-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: ✓NO ES-See Below&Pg. ❑ Pursuant to RCW 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. CONTACT INFORMATION OWNER NAME:EIizabeth CalSyn TENANT BUSINESS NAME If Commercial): OWNER MAILING ADDRESS: STIEET216 Madison St CITY Everett STATE WA ZIP98203 OWNER PHONE:425-387-6065 1OWNER EMAIL:bethsimmons44@gmail.Com CONTRACTOR NAME:Electrical Systems Solutions, Inc. CONTRACTOR ADDRESS: STREETPO BOX 16452 ern Seattle STATE WA ZIP98116 CONTRACTOR PHONEA206) 923 9378 CONTRACTOR EMAIL.rich@elessinc.Com CONTRACTOR LIC.#(REQUIRED):ELECTSS902JN CITY OF EVERETT BUSINESS LIC.#(REQUIRED):65809 PRIMARY CONTACT: []OWNER EDCONTRACTOR []OTHER(Please Specify) CONTACT NAME:Jonathan Alindayu CONTACT P14ONE:206-992-4891 CONTACT EMAIL: AGREEMENT..I hereby certify that/have read and examined this application and know the same to be true and correct All provisions of laws and ordinances goveming this 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 local law regulating constructbrt or the performance of construction. That I am authorized by the owner of this properly to perform the work for which application is made and I comply with the State Law 18.27 RCW and 296.200 WAC. C of Everett Offlclel Use O nly PERMIT#: 4/25/23 JE 2304-163 P "A. L-