2120 W CASINO RD 2019-06-19 - Laserfiche WebLink

ion ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES EVERETT 3200 CEDAR STREET EVERETT WA 9820: WASHINGTON (P)425-257-8810 FAX 425-257-8857 (E)everotteps@everettwa goy] www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 2120 West Casino Road BUILDING AREA: sq ft PROJECT TYPE: El NEW CONSTRUCTION El ADDITION El TENANT IMPROVMENT .D REMODEL BUILDING USE: El SFR 7 TOWNHOUSE El DUPLEX El ADU Ell MULTI-FAMILY #OF UNITS. 7 COMMERCIAL '441101100AL.APPLICAMONWORIVIATIONAVEISCRiPTIONVE:WORK-S- CONTRACT PRICE OF WORK:$ 24,341 ASSOCIATED BUILDING PERMIT#(if applicable): B1812-003 DESCRIBE SCOPE OF WORK: Install 200amp ATS for standby generator THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? E NO 7 YES-Select Scope' RI Service RI Feeder E Circuits-#: E Complete Re-wire LOW VOLTAGE WORK? CI NO 7 YES-#of Devices SELECT SCOPE(REQUIRED) CI Data 1._] Intercom El Thermostat 7 Audio El Secure Access CI Security System El 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. RI Other(List All) Alarming and control : IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: i7,1 NO El YES--See Below&Pg 2 Fa/ By checking this box. I am stating that I have read and understand all of WAC 296-4613-900'selected the specific reason on page 2 vir 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: 'YZNO EYES-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 from this licensing/certification requirement. OWNER NAME: TENANT BUSINESS NAME(If Commercial): 1-Mobile OWNER MAILING ADDRESS: STREET 4010 Leary Way NW Seattle WA op 98107 OWNER PHONE:206-947-5775 OWNER EMAIL:JOhn.Rego@saOW.CoM CONTRACTOR NAME: Legacy Telecommunications CONTRACTOR ADDRESS: S- EsT PO Box 360 crry Burley STATE WA 98322 CONTRACTOR PHONE:253-858-0214 CONTRACTOR EMAIL:riundin©legacypowercom CONTRACTOR LIC.#(REQUIREO,:LEGACTL821LL CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 042661 PRIMARY CONTACT: [DOWNER RICONTRACTOR EOTHER(please Specify) CONTACT NAME: CONTACT PHONE:253-858-0214 Ryan Lundin CONTACT EMAIL:rlundin@legaCypower.com AGREEMENT:I hereby certify that)have rear/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 lam authorized by the owner of this property to perform the work for which application is made and comply with the State Contractors Law 18 27 RCW and 295.200 WAC City 01 Everett Official Use Only PERMIT#: 4/27/19 0 r/Authorized Agent Signature Date (Revised 1/11/2019,1 Page 1-Application