427 MORGAN RD 2019-02-12 - Laserfiche WebLink

ELECTRICAL PERMIT & FIRE ALARM PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES "1111P140 ili 3200 CEDAR STREET, EVERETT, WA 98201 "".1 .� (P)425-257-8810 1 FAX 425-257-8857 1 (E)everetteps@evereftwa.gov 1 www.everettwa.govipermits PROJECT SITE INFORMATION PROJECT ADDRESS:427 Morgan Rd Everett, WA 98203 �1 PROJECT TYPE: 1:3 NEW CONSTRUCTION Ill ADDITION El TENANT IMPROVMENT Q REMODEL BUILDING USE: ❑SFR El TOWNHOUSE El DUPLEX E ADU El MULTI-FAMILY-#OF UNITS: L COMMERCIAL BUILDING AREA: Sq ft ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK:$1,000 IASSOCIATEO BUILDING PERMIT#(if applicable)_ IS THIS LOW VOLTAGE WORK? El NO El YES-#OF DEVICES: 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: Temp Power IS THIS PERMIT EDUCATION,INSITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: ❑NO ❑YES--See Below&Pg.2 riBy checking this box,I am stating that I have read and understand all of WAG 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 YOUAN OWNER PERFORMING WORK AS THE CONTRACTOR WITHOUT ELECTRICAL UCENSURE:ONO ❑YES-See Below&Pg.3 in 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,t 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. i CONTACT INFORMATION OWNER NAME:GREENLEAF GERALD WILLIAM TENANT_BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET 427 MORGANRD ,,Tv EVERETT STATE WA zip 98203 OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME:RVB Electric and Construction CONTRACTOR ADDRESS: STREET2803 Grand Ave cry everett STATE wa zip 98201 CONTRACTOR PHONE:4253449180 CONTRACTOR EMAIL:Office@rvbelectric.corn CONTRACTOR LIC.#(REc1UiRED):RVBELVB84148 CITY OF EVEREI t BUSINESS LIC.#(REOUiRED): 55896 PRIMARY CONTACT: Cl OWNER 0 CONTRACTOR El OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:4259038834 Julie Golub CONTACT ENIA1L:juliya@rvbelectric.com rvbeleotric.com AGREEMENT:I hereby certify that I have read and examined this application and know the same to be true and cones. 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 anyCher 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 whi h apjlica n is made and I comply with the State Contractors Law-18.27 RCW and 296.200 WAG. City of Everett.Official Use Only let O\°\ PERMIT OwnerlAutho zEt Ont nt Signature to (Revised 1i/5!201&) Page 1-Application