3907 HIGH ST 2023-11-01 - Laserfiche WebLink

ll� EVERETT WASHINGTON ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P) 425-257-8810 1 (E) PermitServices@everettv✓e.gov I vwwv.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS:3907 High St BUILDING AREA: 1506 sq It PROJECT TYPE: ❑ NEW CONSTRUCTION [I ADDITION El TENANT IMPROVMENT ✓ REMODEL BUILDING USE: Q SFR []TOWNHOUSE ❑ DUPLEX ❑ ADU ❑ MULTI -FAMILY - # OF UNITS: ❑ COMMERCIA ELECTRICAL APPLICATION INFORMATION & DESCRIPTION OF WORK CONTRACT PRICE OF WORK: $ 4950.00 ASSOCIATED BUILDING PERMIT # (if applicable): DESCRIBE SCOPE OF WORK: Replace old 200 Amp panel with anew 200Amp electrical Panel. Grounding and bonding. Replace old 200 Amp panel with anew 20OAmp electrical Panel. Grounding and bonding. Demo left over knob and tube wiring and rewire old outlets with gorunded one. THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ❑ NO AYES -Select Scope: R Service []Feeder ❑✓ Circuits-#:4 ❑ Complete Re -wire LOW VOLTAGE WORK? ❑ 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 COMPLIANCE IS THIS PERMIT EDUCATION, INSTITUTIONAL, HEALTH AND/OR PERSONAL CARE FACILITIES: ✓ NO Lj 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: ENO 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 1 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:RaChel Fraser TENANT BUSINESS NAME If Commercial): OWNER MAILING ADDRESS: STREET3907 High Str cjTy Everett STATEWA •�/�� A zip 98201 OWNER PHONE:817-713-9222 1OWNER EMAILJraZierach@gmail. Com CONTRACTOR NAME:GalaXy Electric & Solar LLC CONTRACTOR ADDRESS: STREET81 1 NW 193RD ST CITY SHORELINE STATE WA zip98177 CONTRACTOR PHONE:2064141 21 1 1CONTRACTOR EMAIL:Office @galaXyel.Com CONTRACTOR LIC. #(REQU I RED): GALAX ES901 JZ CITY OF EVERETT BUSINESS LIC. #(REQUIRED).49232 PRIMARY CONTACT: ❑OWNER CONTRACTOR []OTHER (Please Specify) CONTACT NAME: Predrag BOJIC IP CONTACT PHONE:206-235-9006 CONTACT EMAIL: pete@galaxyel.com A R N ; I ere y cerwy that I have read an examined this application and know the same to be true and correct. All provisions of laws and oWinances governing Mis type of work will be completed whether specNled hereln 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 construction or the performance of construction. That I am authorized by the owner of this property to perform the work for which appticadm is made and I comply with theJSf9}a Contractors�jr y 16.27 RCW and 296.200 WAC. Ctty of Everett Official Use Only (PERMIT #: �' 06/29/2023 E