2312 BAKER AVE 2019-03-21 - Laserfiche WebLink

ELECTRICAL PMIT & FIRE ALARM P MIT APPLICATION jew":„._ CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 1 FAX 425-257-8857 1 (E)everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT ADDRESS: 23k 2 &c er A-ve Eves +, WA , g0J2D 1 PROJECT TYPE: 0 NEW CONSTRUCTION El ADDITION 111 TENANT IMPROVMENT Y REMODEL BUILDING USE: `Ft SFR El TOWNHOUSE El DUPLEX ❑ADU ❑ MULTI-FAMILY-#OF UNITS: El COMMERCIAL BUILDING AREA: 01 1010(01• I t(O O sq ft = F 4 CONTRACT PRICE OF WORK: f 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) �C� IOW + � ,* e _ . a \� c . wm� _. /Q�'_ 'u A.va�r _ .- .e� -, . � �,�a ,�,........ .... .�_ .�.�..I. ...,... DESCRIPTION OF WORK: -[Op ACV Revv(v''e , Vrnf oqctr oiirwi4 i , rn-cnvv 200 amp pato- l ( Q.ev re in 2-Offt rVonii lom-111 VDO vin IS THIS PERMIT EDUCATION,INSITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: ❑ NO ❑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 YOUAN OWNER PERFORMING WORK AS THE CONTRACTOR WITHOUT ELECTRICAL LICENSURE: ONO EYES-See Below&Pg.3 Pursuant to RCW 19.28.261,propertyowners 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. /4Ye.` ,v.1� ,.xY „�..�� 1 r ,,, � / \ �, OWNER NAME: D V6t(t✓ mount ova TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET \� 2_ BGt r ` ^/Q (��j� CITY " V V. ,,,/� STATE 1/ v' + ZIP V 20 OWNER PHONE: 1)1 OWNER EMAIL: r t CONTRACTOR NAME: In Olit6 � 'EAC V ( J CONTRACTOR ADDRESS: STREET \t2."20 VC1\�-1"tI D "E! CITY L . gVV V ST(A�TE vJ� (?)�2 ✓e) CONTRACTOR PHONE:'g2IOO SZVfCONTRACTOR EMAIL: Inet n JVU(• c/04/1 CONTRACTOR LIC.#(REQUIRED) [IV r►9 ESq9 &1 CITY OF EVERETT BUSINESS LIC.#(REQUIRED) 01414 I LQ PRIMARY CONTACT: ❑OWNER CONTRACTOR LI OTHER(Please Specify) CONTACT NAME:pCONTACT PHONE: 4207( Q 'i�� •�/ -N CONTACT EMAIL: tiqnmitI"� GJ Ge (,l((via) t. AGREEMENT:I hereby certify that 1 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 vro'ate or cancel the provisio s any other state o • : law regulating construction or the performance of construction. That I am authorized by the owner of this property to perform the work f r wh ch application is,ade-'k. I comply with the State Contractors Law 18.27 RCW and 296.200 WAC. ' City of Everett Official Use Only PERMIT# (/- U/4//q t1at Dl- 01 1 Oer!Authorized Agent Signature Date (Revised 11/5/2018) gage 1-Application