3635 COLBY AVE 2023-09-26 - Laserfiche WebLink

• • Mill ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES EVERETT 3200 CEDAR STREET,EVERETT,WA 96201 WASHINSToN (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I v✓ww.everettwa.gov/permits PROJECT SITEt.INFORNI#T1.ON PROJECT ADDRESS: 5 C� Oiby Ave A 7ING AREA: sq ft PROJECT TYPE: ❑NEW CONSTRUCTION Li-ADDITION ❑TENANT IMPROVMtNT ❑REMODEL BUILDING USE: ❑SFR ❑TOWNHOUSE ❑ DUPLEX ❑ADU El MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL ELECT P. TION INFORMATION & DESCRIPTION OF WORK CONTRACT PRICE OF WO :$ N/A- at Fee ASSOCIATED BUILDING PERMIT#(if applicable): _DESCRIBE SCOPE 0 WOR - CDC) Install Install new street ' vice cabinet for Colby Ave - 37th St Traffic Signal THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ❑NO YES-Select Scope:❑✓ Service ✓❑Feeder ❑Circuits-#:_ ❑Complete Re-wire LOW VOLTAGE WORK? ❑NO ❑YES-#of Devices: SELECT SCOPE(REQUIRED): ❑Data ❑Intercom ❑Thermostat ❑Audio El 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 ❑ YES--See Below&Pg. 2 V By tchhis cakpinpgl icthaistiobx(,s Ie ae mn extat tipnag teh)a,tA I NhDv Pe larena Rd eaedw ud NerOstTa nredq aulilofd WbeAcCa u2s9e6-I 4m6e8e9 0a0ll,osf etlheec ftoeldlo wthineg s spuebc tsfelcc trieoanss othna ot nd op angote 2 See Page 2 require Plan Review. ARE YOU AN OWNER PERFORMING WORK AS THE CONTRACTOR WITHOUT ELECTRICAL LICENSURE: ONO DYES-See Below&Pg. 3 / 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: City Of Everett TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET 3200 Cedar St c,n Everett STATE WA zip 98201 OWNER PHONE:425-257-8926 OWNER EMAIL:erichards@everettwa.gov CONTRACTOR NAME: Sail Electric inc. CONTRACTOR ADDRESS: STREET 911 Slater Rd CITY Bellingham STATE WA zip 98226 CONTRACTOR PHONE:360-383-0911 CONTRACTOR EMAIL: CONTRACTOR LIC.#(REQUIRED):SAILEI'066QZ CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 45676 PRIMARY CONTACT: ©OWNER ❑CONTRACTOR ['OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:425-257-8926 Euneka Richards CONTACT EMAIL:erichards@everettwa.gov 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 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 application is made and I comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only PERMIT it. JA4uni AI. si q.1.2020 E Owner/Authorized Agent Signature Date (Revised 1/11/2019) Page 1-Appircau..,