2705 FOREST VIEW DR 2019-03-21 - Laserfiche WebLink

, ,t "op_-,. E LET P ITA LICI HON CITY(CAL OF EVERETT PERMIT SERVICES /4•14.4.1"--g_. 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 1hI OMPRCTST pitt. WK 1 I ? SI PROJECT ADDRESS: 2-70 c r0(),57-- in-.44..- p Y BUILDING AREA: sq ft PROJECT TYPE: 0 NEW CONSTRUCTION 0 ADDITION 0 TENANT IMPROVMENT RI REMODEL BUILDING USE: SFR 0 TOWNHOUSE 0 DUPLEX 0 ADU 0 MULTI-FAMILY #OF UNITS COMMERCIAL j t .y EE R 44l*: IPA'Fg/m9NORryTfOt Fgg: . ` x . CONTRACT PRICE OF WORK:$ fJ (ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: / ip4'e 1,4,/✓e A2( gh'ei7/( / cwrh6'-e( THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? 0 NO LYES-Select Scope: 0 Service 0 Feeder 0 Circuits-#: 0 Complete Re-wire LOW VOLTAGE WORK? tI NO 0 YES-#of Devices: SELECT SCOPE(REQUIRED): ata 0 Intercom 0 Thermostat 0 Audio '0 Secure Access 0 Security System 0 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. 0 Other(List All): /► 'y1 �{ _ J4 _..k 'Y j3. �`r,. $, �-tet ,-kms �. \.. S, rs.^ AL'",PAI9� SW E W zli r-._ .e„ _.'4.�v- ,-agef IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: 14 NO 0 YES—See Below&Pg.2 0 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 OYES-See Below&Pg.3 El 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. n �S }... ��,�"zS.Ha. ,.�t) ,,ti�e a�, i t�N T: / �Ri/ VVIC M Vii.J,'Y�:xaS r..,3.t 1.u...a` Z.,^;k1,3....ar .aw:...,s ad.+ $ss�.�`�'�t 3�'H'�1�:'��' �. ';.� SL+M k au ,..�. �z�� + � .. ten,� :.,... ' .. OWNER NAME: filo9P(ft— PAW anvil) TENANT BUSINESS� NAME If Commercial): OWNER MAILING ADDRESS: STREET 2 7o for./41-'4for./41- 1✓ :7'W.-- V r CITY/✓ � /��/ � � STATE VVI ZIP 96".?-agr OWNER PHONE: y v/ (OWNER EMAIL: ^-- - ....e, CONTRACTOR NAME: Wi(eI /7' l'I( r�- �7 Pili i' 67 CONTRACTOR ADDRESS: , STREETe�,�r 3 3�^ .�/o��i � j . c1TYP /�///(free-, / STATE W ZIP 9012- CONTRACTOR �/7 (CONTRACTOR EMAIL: -ef!(6)Wrlf i'/7'c77i , TC .1 CONTRACTOR LIC.#(REQUIRED): me P C) 1 96—L t ICITY OF EVERETT BUSINESS LIC.#(REQUIRED): PRIMARY CONTACT: 0 OWNER NI CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 4/ L ?..3 Z 6/7/ J ///fl/f%!//J'lt CONTACT EMAIL: e/ 1/1 -,c,' -r/iTY/ r ,'`!c#e'474 AGGREEEMENNT!hereebycertify that t 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 wok for Ewhictt Oh pica i n s Only ye and 1 comply with the State Contr tors Law 1 .27 RCW and 296.20Q.WAC. CitPERMIT#: 7 • - /9. 7, .i. 0 er/Auth M ized gent Signature Date (Revised 1/11/2019) Page 1-Application