6232 COMMERCIAL AVE 2019-03-14 - Laserfiche WebLink

ELECTRICAL ARMIT & FIRE ALARM PMIT APPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: &J S („L( Yt/�, f4P 58lZz)C,1� PROJECT TYPE: ❑NEW CONSTRUCTION El ADDITION El TENANT IMPROVMENT El REMODEL BUILDING USE: ®.SFR El TOWNHOUSE El DUPLEX El ADU El MULTI-FAMILY-#OF UNITS: El COMMERCIAL BUILDING AREA: sq ft ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK:$ ,300111(.A:1 lltr ASSOCIATED BUILDING PERMIT#(if applicable): IS THIS LOW VOLTAGE WORK? El NO El YES-#OF DEVICES: IS THIS A FIRE ALARM PERMIT? ❑ NO El YES-Plans required for review(Both Electrical and Fire Department inspections are required) DESCRIPTION OF WORK &CODE COMPLIANCE DESCRIPTION OF WORK: /WO C..(C-C.L I T (Z, R.v 3 D/lyvtf I au v IS THIS PERMIT EDUCATION,INSITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: g NO El YES--See Below&Pg.2 fl 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 EYES-See Below&Pg.3 IEl l 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: k L.K-�VY\ (As t C3STENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET b �j C. vnc r C\c4 Ave_. CITY G,,i -re-lt" STATE Lk ZIP OWNER PHONE: Li —aZc:1-6d 31 I OWNER EMAIL: CONTRACTOR NAME: L o e4)#,r/ E1e-i} i G) I4vC CONTRACTOR ADDRESS: sTREEr ,�-1 0"3 go— 1 CO i tb J T v .. SE cm �7 Yin O 11'1 I S STATE W l z�P 7 Q a 9O CONTRACTOR PHONE:1425 1{$$6l5 D CONTRACTOR EMAIL: `Q fw€,MI .E.l ec/-Ific IZf7ti*'l.LIJ . cF tvi CONTRACTOR LIC.#(REQUIRED): L O. W LL=94/11d F CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 0 L/(p 0 58 PRIMARY CONTACT: IZOWNER El CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: £4 a,` — '� 1 I L ) <<-- —I•/Yfl CONTACT EMAIL: AGREEMENT:I hereby certify that I have read and examined this application and know the same to be true and con-ect. 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 d l comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only PERMIT# 18A/h rji/H,61'0 Owner/Authorized Agent Signature Date (Revised 11/5/2018) Page 1-Application