5818 EAST DR 2023-09-26 - Laserfiche WebLink

INEN ® ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES EVERETT 3200 CEDAR STREET,EVERETT,WA 98201 WASHINGTON (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 5818 East Drive BUILDING AREA: sq ft PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ADDITION ❑ TENANT IMPROVMENT 0 REMODEL BUILDING USE: 0 SFR ❑ TOWNHOUSE El DUPLEX ❑ADU El MULTI-FAMILY-#OF UNITS: ❑ COMMERCIAL ELECTRICAL APPLICATION INFORMATION & DESCRIPTION OF WORK CONTRACT PRICE OF WORK: $ Q '(.)(j: ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: upgrade electrical service from 125 AMP to 200 AMP THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ❑ NO ❑YES-Select Scope: 0 Service ❑Feeder ❑Circuits-#: El Complete Re-wire LOW VOLTAGE WORK? 0 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: J❑ 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: ENO EYES-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: Jody L. Azure-Hawkins TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET 5818 East Drive my Everett STATE Vv 1A, A Z,P 98203 OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: Owner CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LIC.#(REQUIRED): ICITY OF EVERETT BUSINESS LIC.#(REQUIRED): PRIMARY CONTACT: El OWNER ❑CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:425-923-4833 Jody CONTACT EMAIL:)OdyWithaWhy@gmail.COm 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 specied herein or ot. 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 ction or th performance of co struction. 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 Con ctors L w 18.27 RCW and 96.200 WAC. City of Everett Official Use Only PERMIT#: ( 1 / 6/14/19 ` � ' \\\i ?) Owrier/Ruth nt ig ture I Date (Revised 1/11/2019) Page 1-Application