6125 SYCAMORE PL 2024-05-02 - Laserfiche WebLink

EVERETT WASHINGTON ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P) 425-257-8810 1 FAX 425-257-8857 1 (E) everettnps@evereltwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 6125 Sycamore PI BUILDING AREA: 1200 sq It PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ ADDITION ❑ TENANT IMPROVMENT ✓❑ REMODEL BUILDING USE: SFR ❑ TOWNHOUSE ❑ DUPLEX ❑ ADU ❑ MULTI -FAMILY - # OF UNITS: ❑ COMMERCIAL ELECTRICAL APPLICATION INFORMATION & DESCRIPTION & WORK CONTRACT PRICE OF WORK: $ 6000 ASSOCIATED BUILDING PERMIT # (if applicable): B2109-076 DESCRIBE SCOPE OF WORK: Complete house rewire THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ❑ NO ❑✓ YES - Select Scope: R1 Service ❑✓ Feeder ❑✓ Circuits-#:30 ❑ Complete Re -wire LOW VOLTAGE WORK? ❑ NO Q YES- # of Devices:7 SELECT SCOPE (REQUIRED): 21 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 1S THIS PERMIT EDUCATION, INSTITUTIONAL, HEALTH AND/OR PERSONAL CARE FACILITIES: 21 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: ]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/cerlification requirement. CONTACT INFORMATION OWNER NAME: Tlmofey LapatSln TENANT BUSINESS NAME (If Commercial): OWNER MAILING ADDRESS: STREET 6125 Sycamore PI Cm Everett TAUWA IP 98203 OWNER PHONE:425 737 2259 1OWNER EMAJL:timlapatsin@yahoo.com CONTRACTOR NAME: n/a CONTRACTOR ADDRESS: sIRE tI CnY STATF ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LIC. #(REQUIRED): CITY OF EVERETT BUSINESS LIC. #(REQUIRED): PRIMARY CONTACT: ❑✓ OWNER ❑CONTRACTOR ❑OTHER (Please Specify) CONTACT NAME: Tim Lapatsin CONTACT PHONE:425 737 2259 CONTACT EMAIL:timlapatsin@yahoo.com AGREEMENT I hereby cwh/y that I have road and ezaa~ this application and know the same to be true and correct All provisions of laws and ordinances governing this fyW of Mark will be conpleted wf)Ww speared herein or not The granting of a permit does not presume to give authority to vitiate or cancel the provisions of any other state or local Jaw regulating construction or the perfmnarice of construction. That I am ataborized by the owner of this property to perform the work for which application is made and I coney with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only PERMIT #: 4/4/2022 owner/Authorized Agent Signature Date (Revised 1/11/2019) Page 1-Application