2821 106TH ST SE 2023-12-11 - Laserfiche WebLink

• • 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: 2821 106TH ST SE BUILDING AREA: 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:$ 350 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: AIR HANDLER CHANGE OUT ADD HP 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 El 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 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: EINO 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: Brian Collins TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET 2821 106TH ST SE CITY EVERE T STATE era ZiP 98205 OWNER PHONE: 757-344-3618 OWNER EMAIL: Mustany658@aol corn CONTRACTOR NAME: MM COMFORT SYSTEMS CONTRACTOR ADDRESS: STREET 18103 NE 68TH ST SE. C-200 cm( REDMOND STATE WA 2IP 98052 CONTRACTOR PHONE: 425-881-7920 CONTRACTOR EMAIL: PERMITS@MMCOMFORTSYSTEMS.COM CONTRACTOR LIC.#(REQUIRED): M COMCSB39PT CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 055245 PRIMARY CONTACT: ❑OWN ER CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 425-629-1 0255 Jenah Barlow CONTACT EMAIL: PERMITS@MMCOMFORTSYSTEMS.COM AGREEMENT I hereby certify that t 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#, J� -- ' -7� �. zU E 2b 0\ OwnerflAutKorized Agent Signature Date (Revised 111 112 0 1 9) Page 1-Application