2221 COLBY AVE 2024-02-09 - Laserfiche WebLink

® • ELECTRICAL PERMIT APPLICATION EVERETT CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 W ASHINGTOM (P)425-257-8810 FAX 425-257-8857 j(E)everetfeps@everettwa.gov i www.everettwa.gov/permits T ECT ST INFORMATION o wry.. PROJECT ADDRESS: 2221 Colby Ave BUILDING AREA: 1000 sq ft PROJECT TYPE: El NEW CONSTRUCTION ❑ADDITION Z TENANT IMPROVMENT ❑ REMODEL BUILDING USE: SFR ❑TOWNHOUSE El DUPLEX ❑ADU El MULTI-FAMILY-#OF UNITS: El COMMERCIAL ELECTRICAL APPLICATION INFORMATION 11R DESCRIPTION OF WORK CONTRACT PRICE OF WORK:$ 870 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: 50 amp spider cord for existing 200 amp panel THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? El NO Z YES-Select Scope: Z Service ❑ Feeder �1 ❑Circuits-ft ❑ 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 CE . �`. 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: ✓❑INO 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 NFOR.. ... ._ OWNER NAME: 2221 Colby LLC TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET PO Box 5616 CITY Everett STATE WA pp 98206 OWNER PHONE:(206) 573-0613 OWNER EMAIL:jessicar@mcbrideconstruction.com CONTRACTOR NAME: D&K Electric, Inc. CONTRACTOR ADDRESS: STREET PO BOX 2117 CITY Lynnwood STATE WA ZIP 98036 CONTRACTOR PHONE:425-742-7654 CONTRACTOR EMAIL:dandkelectric@comcast.net CONTRACTOR LIC.#(REQUIRED):DKELEK970KK CITY OF EVERETT BUSINESS LIC.#(REQUIRED):040151 PRIMARY CONTACT: ❑OWNER ECONTRACTOR MOTHER(Please Specify) CONTACT NAME• CONTACT PHONE: ��79 . )4 he�/ CONTACT EMAIL: at C C- C O + C : AGREEMENT./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 or wont will De completeo 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#: tt E , AwnerlAuthorized Agent Signature Date (Revised 1/11/2019) Page 1-Application