7417 JEFFERSON AVE 2019-03-28 - Laserfiche WebLink

ELECTRICAL PERMIT & FIRE ALARM PERMIT 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.govl www.everettwa.gov/permits 1,RP40.018111 101:1AttORe''''''''', 3-*4 PROJECT ADDRESS:7417 JEFFERSON AVE PROJECT TYPE: 0 NEW CONSTRUCTION Li ADDITION Ci TENANT IMPROVMENT El REMODEL BUILDING USE El SFR 0 TOWNHOUSE 0 DUPLEX CI ADU El MULTI FAMILY-#OF UNITS 0 COMMERCIAL BUILDING AREA. 1824 sq ft • : 0e4Y%,,,,tig.LECtit:IWAOLibailtVOLINFO,R61 CONTRACT PRICE OF WORK:$250 ASSOCIATED BUILDING PERMIT#(it applicable): IS THIS LOW VOLTAGE WORK? 0 NO El YES-#OF DEVICES: IS THIS A FIRE ALARM PERMIT? 10 NO El YES-Plans required for review(13oth Electrical and Fire Department in-Spec:60ns are required) •;V: 'friF DescRwrio - Da com = DESCRIPTION OF WORK: LIKE IN KIND 41HAND1ER CHANGE OUT NTH UA PUMP INSTALLATION ---- -1-10N-e-vvvo.s-Vv—k- e-c---h IS THIS PERMIT EDUCATION,INSITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: NO El 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 YOU AN OWNER PERFORMING WORK AS THE CONTRACTOR WITHOUT ELECTRICAL LICENSURE:ZINO DYES-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 signed the See Page 3 AFFIDAVIT on page 3 of this application to receive an exemption from this licensing/certification requirement. cOq*P71 1441 F PAMAT I 4) OWNER NAME:PHIL MANSFIELD TENANT BUSINESS NAME(If Commerdal):. OWNER MAILING ADDRESS: STREET 7417 JEFFERSON AVE c,,, EVERETT STATE WA ZIP 98203 OWNER PHONE425-870-2283 CONTRACTOR NAME C.M. HEATING INC CONTRACTOR ADDRESS! STREET 1415 BROADWAY me EVERETT • • • WA zip 98201 CONTRACTOR PHONE:425-259-0550 CONTRACTOR EMAIL:KAILANA@CMHEATING.COM CONTRACTOR LIC.#(REDUIREO),CMHEAMH877DN 'CITY OF EVERETT BUSINESS LIC REQUIRED 016098= PRIMARY CONTACT: DOWNER EJ CONTRACTOR CI OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:425-259-0550 KAI LANA CONTACT EMAIL:KAILANA@CMHEATING.COM AGREEMENT hereby certify that I 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 am authorized by the owner of this property to perform the I work for which application is made and comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only PERMIT# I?)\ #44' Lefitl4 71104,1: 12/28/18 Owner/Authorized Agent Signature • Date (Revised 11/5/2018) Page 1-ApplIcation