1511 OAKES AVE 2025-01-27 - Laserfiche WebLink

I• ELECTRICAL PERMIT APPLICATION EVERETT CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 WASHINGTON (P)425-257.8810 1 FAX 425.267-8857 1(E)everetteps@everettwa.gov i www.everettwo.govlpermits RROJECT $IT INFORMATIOM PROJECT ADDRESS: BUILDING AREA: 1800 sq ft PROJECT TYPE: ❑ NEW CONSTRUCTION 0 ADDITION ❑TENANT IMPROVMENT ❑ REMODEL BUILDING USE: ❑✓ SFR ❑TOWNHOUSE ❑ DUPLEX ❑ADU ❑ MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL .�CTR� AE.AIP LICA �Q�1 1M aRtVIAT oN 8� PESGRIPT�S�t! 0 Ulfof if CONTRACT PRICE OF WORK:$ N/A 1ASSOCIATED BUILDING PERMIT#(If applicable): DESCRIBE SCOPE OF WORK: Residential add-on with new sub panel THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ❑ NO ©YES-Select Scope; ❑Service © Feeder ❑Circuits-#:14 ❑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 Ali): ......... .... ..... .. .... OODE cOMPLIANCI: IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: WINO 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 OYES-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 INFOIRMATION. OWNER NAME: Mike Wilkinson TENANT BUSINESS NAME if Commercial): OWNER MAILING ADDRESS: STREET 1511 Oakes Ave Cry everett STATE wa Zlp 98201 OWNER PHONE:425-309-9448 IOWNEIR EMAIL:mikewilkinson2010@yahoo.com CONTRACTOR NAME: CONTRACTOR ADDRESS: STREET 1 CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LIC.#(REQUIRED):N/A CITY OF EVERETT BUSINESS LIC.#REQUIRED):N/A PRIMARY CONTACT: ©OWNER ❑CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: CONTACT EMAIL: AGREEMENT.l 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 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/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#: Mike Wilkinson • 6/18/2020 JE .. Owner/Authorized Agent Signature Dale (Revised 1/f 112019) Page 1-Application