11103 3RD PL SE 2025-03-24 - Laserfiche WebLink

ELECTRICAL PERMIT APPLICATION EVERETT 32CITY OF EVERETT PERMIT SERVICES 00 CEDAR STREET,EVERETT,WA 98201 WASHINGTON (P)425-257-8810 1 FAX 425-257-8857 1(E)everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 11103 3rd PL SE Everett WA 98208 BUILDING AREA: 2405 sq ft PROJECT TYPE: El 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: $ 29,274.00 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: 6.97okWDC roof mounted solar install on existing home THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ❑ NO ❑YES-Select Scope:F] Service ❑ Feeder 0 Circuits-#: 1 ❑ Complete Re-wire LOW VOLTAGE WORK? E] 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): Solar PV CODE COMPLIANCE IS THIS PERMIT EDUCATION, INSTITUTIONAL, HEALTH AND/OR PERSONAL CARE FACILITIES: NO Ll YES--See Below&Pg. 2 ❑ By checking this box, I am stating that I have read and understand all of WAC 296-46113-900,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/certification requirement. CONTACT INFORMATION OWNER NAME: Dave Ferguson TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET 11103 3rd PL SE Everett WA 98208 CITY Everett STATE WA zip 98208 OWNER PHONE: 425-737-6853 OWNER EMAIL: df5557@gmail.com CONTRACTOR NAME: Solgen Power LLC CONTRACTOR ADDRESS: STREET 6752 20th St E STE 200 CITY Fife STATE WA zip 98424 CONTRACTOR PHONE: (206)649-9976 CONTRACTOR EMAIL: picseattle@purelightpower.com CONTRACTOR LIC.#(REQUIRED): SOLGEPL830RJ CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 62231 PRIMARY CONTACT: DOWNER FLICONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: Joseph Kwon CONTACT PHONE: (206)649-9976 CONTACT EMAIL: picseattle@purelightpower.com AGREEMENT:/hereby certify that/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 1 am authorized by the owner of this property to perform the work for which application is made and 1 comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only Q /� PERMIT#: JoT/�h -`wu 09/19/2024 E Owner/Authorized Agent Signature Date (Revised 1/1 112 0 1 9) Page 1-Application Document Ref:ME9KR-YHUGT-NB7JY-MVWQ3 Page 1 of 1