4721 BAYVIEW LN 2026-01-16 - Laserfiche WebLink

ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES EVERETT 3200 CEDAR STREET, EVERETT, WA 98201 WASNINAT (P) 425-257-8810 1 (E) PermitServiceg0Pvarratwa nnv I 1AAAAA/P\/PrP}}.n/� nnv/normi4c PROJECT SITE INFORMATION PROJECT ADDRESS:4721 bayview lane everett wa 98203 BUILDING AREA: 2700 scl 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: $300 ASSOCIATED BUILDING PERMIT # (if applicable): none DESCRIBE SCOPE OF WORK: moving light from above garage door to either side of garage, along with installing outlet on the back of garage moving light from above garage door to either side of garage, along with installing outlet on the back of garage THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ❑ NO Q YES - Select Scope: ❑ Service ❑ Feeder ❑ Circuits-#: 1 ❑ Complete Re -wire LOW VOLTAGE WORK? ❑r 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: Ll NO U YES -- See Below & Pg. 2 By checking this box, I am stating that I have read and understand all of WAC 296-466-900, 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. Pursuant to RCW 19.28.261, property owners and leaseholders cannot perform electrical work on buildings for rent, sale, or lease Q 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: TENANT BUSINESS NAME (If Commercial): OWNER MAILING ADDRESS: STREET CITY STATE ZIP OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LIC. #(REQUIRED): CITY OF EVERETT BUSINESS LIC. #(REQUIRED): PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR []OTHER (Please Specify) CONTACT NAME: ryan wright AC;RFFAAFNT• ! hPrah. rortifi, eh�r I fig,,,, .,.-.,� .,.............:.._,, ,�:_ CONTACT PHONE:2067949002 CONTACT EMAIL:ryan _--"--"-- -- - - - •-1^— « aNN ,tea ,�„ a„u n/ww u/e same io oe True ana 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/ comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only PERMIT #: 3 E Own /Authorized Agent Signature Date (Revised 41512022) Page 1-Application