2310 RAINIER AVE A 2019-04-29 - Laserfiche WebLink

CITY OF EVERETT PERMIT SERVICES 001111111W--- �—� 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 ~' 1 OJECT SITE NFORMATION' -- PROJECT ADDRESS: ? O PIettrift - J t v`t✓ 1,d qU 6t PROJECT TYPE:nNEW CONSTRUCTION ADDITION !lel' ENANT IMPROVMENT EIREMODEL BUILDING USE: 11-311 SFR a TOWNHOUSE 0 UPLEX 0 •DU 0 lULTI-FAMILY-#OF UNITS: 0 COMMERCIAL BUILDING AREA: sq ft - ELECThIRICA1.APP N UCATIOINFORMATION LL CONTRACT PRICE OF WORK:$ w�� ASSOCIATED BUILDING PERMIT#(if applicable): IS THIS LOW VOLTAGE WORK? CI NO ES-#OF DEVICES: I +-415Lt- IS THIS A FIRE ALARM PERMIT? NO 0 YES-Plans required for review(Both Electrical and Fire Department inspections are required) DESCRIPTION tOF WORK&COD "COMPLIANCE DESCRIPTION OF WORK: ç1rL LOW VOtt O\ 1 +7.--s4-6d- THIS --s -THIS SECTION APPLIES TO ALL EDUCATION,INSITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: Du 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 I 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. ATTENTION OWNERS:THIS SECTION IS FOR OWNERS PERFORMING WORK AS THE CONTRACTOR WITHOUT ELECTRICAL LICENSURE: ■1 Pursuant toelectricRCW 19.28.261,property owners and leaseholders cannot perform electrical work on buildings for rent,sale,or lease without the proper al 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 INFOt MATION OWNER NAME: C(.p r( 7 C- TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET 6,151 .� pVt 1¶i St p CITY ge f, p"` STATE A- zip gOodts OWNER PHONE: ( ) t9 if -q ry�i OWNER EMAIL: 1 P t C C.CIr-M iC g. f,fru. (.C,uWv_ CONTRACTOR NAME: ris,i j(J S 141 ..IA-C.. CONTRACTOR ADDRESS: STREET /&J 3') �J qq CnYr I�l.t t-1IV STATE GA- zi, q 8636 CONTRACTOR PHONE:tt r�- -s-0CONTRACTOR EMAIL: pYI,t VL{ 4 .ca CONTRACTOR LIC.#(REQUIRED): KIN&5 ® 'd A- CITY OF EVERETT BUSINESS LIC.#(REQUIRED): ) PRIMARY CONTACT: :1 *INNER _CONTRACTOR LrIOTHER(Please Specify) CONTACT NAME: CONTACT PHONE: '60 G 50,(0,..k cCouvL(c. CONTACT EMAIL: 3 im cit>rfn;C _.0 IAA-Mad(..ct,(Y"\. AGREEMENT*I 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 I am authorized by the owner of this property to perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only ei.' ' PERMI # l 11/3/� t OOCo �.....e.�w..+ti...cs.4 w..e..F ....��.,.e n,ro /Dn..icn`!-111//1/911-1111 Donn 1..f Z