1728 W MARINE VIEW DR BASE FILE 2024-10-16

ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES EVERETT 3200 CEDAR STREET, EVERETT, WA 98201 WP 495-957-11FHO I lP1 PPrmitSwrvlrpaCn) Rvnrpttwa nov I vA&w Avprpttwa nnvinarmitc PROJECT ADDRESS:1728 west Marine View Dr STE 109 1BUILDING AREA: sq ft PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ ADDITION ❑TENANT IMPROVMENT ✓❑ REMODEL BUILDING USE: ❑ SFR []TOWNHOUSE [—]DUPLEX ❑ ADU ❑ MULTI -FAMILY - # OF UNITS: ❑✓ COMMERCIAL CONTRACT PRICE OF WORK: $1500.00 JASSOCIATED BUILDING PERMIT # (if applicable): I DESCRIBE SCOPE OF WORK: Disconnect existing HVAC Unit Reconnect new HVAC UNIT LIKE FOR LIKE Disconnect existing HVAC Unit Reconnect new HVAC UNIT LIKE FOR LIKE THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ❑ NO [D YES - Select Scope: ❑ Service ❑ Feeder ❑ Circuits-M ❑ 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): IS THIS PERMIT EDUCATION, INSTITUTIONAL, HEALTH AND/OR PERSONAL CARE FACILITIES: U NO LJ YES --See Below & Pg. 2 a 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 ES -See Below & Pg. ❑ 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. OWNER NAME:POrt Of EVERETT TENANT BUSINESS NAME If Commercial): OWNER MAILING ADDRESS: sTREETPO Box 538 TY Everett STATE Wa zjP 98206 OWNER PHONE.4257654678 OWNER EMAIL:webSterelectricllc@outlook.com CONTRACTOR NAME:Webster Electric LLC CONTRACTOR ADDRESS: STIIIT13315 208th Ave NE ,.T,, Woodinville STATE Wa Z,P98077 CONTRACTOR PHONE:4257654678 1CONTRACTOR EMAIL:Webstereletriciic@Outlook.cOm CONTRACTOR LIC. #(REQUIRED):WEBSTEL844NT CITY OF EVERETT BUSINESS LIC. #(REQUIRED): PRIMARY CONTACT: ❑OWNER ❑✓ CONTRACTOR []OTHER (Please Specify) CONTACT NAME: CONTACT PHONE:4257654678 Brad Webster JCONTACT EMAIL: websterelectridIc@outtook.com AGREEMENT t hereby certify that t have read and examined this application and know the same to be (rue and correct. All provislons of laws and ordinances governing this type of wark wilt 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 stale 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 l comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only PERMIT M 1 /23/24 E '�- 4-D -Z. -- o 33 wnerl&flhorized Agent Signature Date (Revised 41512022) Page 1-Application