2228 WETMORE AVE 2019-05-22 - Laserfiche WebLink

EL CT 'CAL PER IITAiTLIIIHON CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 (P)425-257-8810 ► FAX 425-257-8857 ►(E)everetteps@everettwa.gov►®www.everettwa.gov/permits 4 i PROJECT ADDRESS: 22?FS IA)el-0401/e 9 ' O I BUILDING AREA: sq ft PROJECT TYPE: 0 NEW CONSTRUCTION 0 ADDITION 0 TENANT IMPROVMENT 0 REMODEL BUILDING USE: 0 SFR 0 TOWNHOUSE 0 DUPLEX 0 ADU D MULTI FAMILY #OF UNITS: ►i COMMERCIAL CONTRACT PRICE OF WORK:$ /OD v, D 0 'ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: Glnav1 e out -Hou/esca., LED r&' :s / cI d n 4o /2o Vo 1.1- G'✓cur't Foes ,9vo J'ecab THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? 0 NO ®YES-Select Scope: 0 Service 0 Feeder 0 Circuits-#: / 0 Complete Re-wire LOW VOLTAGE WORK? 0 NO 0 YES-#of Devices: SELECT SCOPE(REQUIRED): 0 Data 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): J c iIMummi in tv4ai X, ys4. 'yy ' ..Rixs wwl�i inft li 4S ..` +5..'4,s��n(ri.'Sk ?W"' `RS v Ming .Mi IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: L9 NO O YES—See Below&Pg.2 DBy 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 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 See Page 3 signed the AFFIDAVIT on page 3 of this application to receive an exemption xemption from this licensing/certification requirement. W ERMOS4OyCOOyy /VONIy TR xMORLM Vi x . OWNER NAME: 8I b le 1.0 ay c_-6 uvCk TENANT BUSINESS NAME(If Commercial): f/0 Way t_4 u"c k OWNER MAILING ADDRESS: STREET 22 2? LJ eflA4 ove Q 3 CITY Eu eve " - STATE 4A11 ZIP /9201 OWNER PHONE: N 2$731 - `I'131 'OWNER EMAIL: VYIa!ict 1 clay 6% .„yet6a°'.Cavi ,. CONTRACTOR NAME: /9 On o vawl EleGfvsc CONTRACTOR ADDRESS: STREET 5/C 4 v� " 4 i 2 n CITY S vr0 h o me 6.114 s 4 STATE ZIP.9a 2? CONTRACTOR PHONE:q/25 Ztly—UZQ 'CONTRACTOR EMAIL: f2oi'ovaH . E G66123 a ' CONTRACTOR LIC.#(REQUIRED): f�»pI S 2�Y•lt( ''CITY OFEVERETT BUSINESS LIC.#(REQUIRED): b b 3 , PRIMARY CONTACT: ID OWNER Ig CONTRACTOR 0 OTHER(Please Specify) b CONTACT NAME: f� CONTACT PHONE: 9 25 2y1/—9`28 00novavl /` oS If/7,q CONTACT EMAIL: 0000ueto . EIe.C'fyk' Q &N1&i1 • 641141 AGREEMENT:I hereby certify that I hav 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 wor rk for Ewhictt Optic atli n s Only ye is and I comply with the State Contractors Law 18.27 RCW and 296.200 WAC. CitPERMIT#: 1/z,,// 9 EICA6 \ 1 \ Owner/Authorized Agent Signa u Date (Revised 1/11/2019) Page 1-Application