910 91ST PL SW 2023-10-23 - Laserfiche WebLink

D -: FDC48024-CF2D-41 E6-9C6B-8C6509293DA8 ELECTRICAL PERMIT APPLICATION EVERETT 32CITY OF EVERETT PERMIT SERVICES 00 CEDAR STREET,EVERETT,WA 98201 WASHINGTON (P)425-257-8810 1 FAX 425-257-8857 1(E)everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 910 91ST PL SW EVERETT WA 98204 1 BUILDING AREA: sq ft PROJECT TYPE: ❑ NEW CONSTRUCTION X❑ ADDITION ❑ TENANT IMPROVMENT ❑ REMODEL BUILDING USE: X❑ SFR ❑ TOWNHOUSE ❑ DUPLEX ❑ ADU ❑ MULTI-FAMILY-#OF UNITS: ❑ COMMERCIAL ELECTRICAL APPLICATION INFORMATION & DESCRIPTION OF WORK CONTRACT PRICE OF WORK: $ 11,558 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: PV SOLAR ROOF MOUNT AND MAIN ELECTRICAL PANEL UPGRADE THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ❑ NO X❑YES-Select Scope: X❑ Service X❑ Feeder X❑ Circuits-#:4 ❑ Complete Re-wire LOW VOLTAGE WORK? X❑ 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. X❑ Other(List All):SOLAR CODE COMPLIANCE IS THIS PERMIT EDUCATION, INSTITUTIONAL, HEALTH AND/OR PERSONAL CARE FACILITIES: 71 NO Ll 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 El 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: X❑NO —]YES-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: SHANNON SMITH TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET 910 91ST PL SW CITY EVERETT STATE WA ZIP 98204 OWNER PHONE:425)583-3739 OWNER EMAIL:shankat@comcast.net CONTRACTOR NAME: SOLGEN POWER CONTRACTOR ADDRESS: STREET 1992 SAINT STREET CITY RICHLAND STATE WA ZIP 99354 CONTRACTOR PHONE:509-505-6834 CONTRACTOR EMAIL:NICOLE.RELYEA@SOLGENPOWER.COM CONTRACTOR LIC.#(REQUIRED):SOLGEPL820RJ CITY OF EVERETT BUSINESS LIC.#(REQUIRED): PRIMARY CONTACT: DOWNER ECONTRACTOR ❑OTHER(Please Specify) CONTACT NAME:NIKKI CONTACT PHONE:509-5056834 CONTACT EMAIL:NICOLE.RELYEA@SOLGENPOWER.COM AGREEMENT:/hereby certify that/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 1 am authorized by the owner of this property to perform the work for which application is made and 1 comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only Docusigned by: PERMIT#: 3/10/2021 E 621 B49042FE5482... Owner/Authorized Agent Signature Date (Revised 1/11/2019) Page 1-Application