1616 126TH ST SE 2025-01-29 - Laserfiche WebLink

, ELECTRICAL AMIT & FIRE ALARM PE. _.AIT APPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 I FAX 425-257-8857 I (E) everetteps©everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 1616 126th St SE PROJECT TYPE: EW C NSTRUCTION ❑✓ ADDITION ❑ TENANT IMPROVMENT ❑✓ REMODEL BUILDING USA SFR TOWNHOUSE ❑ DUPLEX ❑ADU ❑ MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL BUILDING AREA: 2861 sq ft ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $4000 ASSOCIATED BUILDING PERMIT#(if applicable): C1710-015 IS THIS LOW VOLTAGE WORK? ❑ NO ✓❑ YES-#OF DEVICES:5 IS THIS A FIRE ALARM PERMIT? ✓❑ NO ❑ YES-Plans required for review(Both Electrical and Fire Department inspections are required) DESCRIPTION OF WORK & CODE COMPLIANCE DESCRIPTION OF WORK: House rewire, thermostat and network wiring IS THIS PERMIT EDUCATION, INSITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: ✓❑ NO ❑YES--See Below&Pg.2 r 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 1 _ 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. ri---��ll l-;1 ARE YOU AN OWNER PERFORMING WORK AS THE CONTRACTOR WITHOUT ELECTRICAL LICENSURE: UNO 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 signed the See Page 3 AFFIDAVIT on page 3 of this application to receive an exemption from this licensing/certification requirement. CONTACT INFORMATION OWNER NAME: Anne Myers& Steve Kreger TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET 1616 126th St SE cin, Everett STATE WA ZIF, 98208 OWNER PHONE: 425-478-4681 OWNER EMAIL: steve@kreger.org CONTRACTOR NAME: Self 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: CONTACT PHONE: 425 478 4681 Steve Kreger CONTACT EMAIL: steve@kreger.org AGREEMENT 1 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 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# t q4q E l't0( -059 Owner/Authorized Agent Signature Date (Revised 11/5/2018) Page 1-Application