4416 RIVERFRONT BLVD 2019-06-25 - Laserfiche WebLink

t• ELECTRICAL PERMIT APPLICATION EVERETT CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 WASHINGTON (P)425-257.8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov www.everettwa.govfpermits PROJECT SITE INFORMATION .".,S, .. PROJECT ADDRESS: 4416 Riverfront Blvd BUILDING AREA: sq ft PROJECT TYPE: ❑NEW CONSTRUCTION ❑ADDITION ❑TENANT IMPROVMENT 0 REMODEL BUILDING USE: SFR ❑TOWNHOUSE ❑DUPLEX ❑ADU 0 MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL ELECTRICAL APPI:ICATION,INFORMATION 'r DESCRIPTION CIF.WORK.,Il CONTRACT PRICE OF WORK:S 700 'ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: 50 amp car charger THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE:(SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ❑NO 0 YES-Select Scope:❑Service ❑Feeder 0 Circuits-#:1 El Complete Re-wire LOW VOLTAGE WORK? El NO ❑YES-#of Devices: SELECT SCOPE(REQUIRED): ❑Data ❑Intercom 0 Thermostat 0 Audio ❑Secure Access El 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. ❑Other(List All): CODE COMPLIANCE < IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: rn NO El YES—See Below&Pg.2 17 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: [INC EIYES-See Below&Pg.3 ._W._ 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. . '. CONTACT.INFORMATION OWNER NAME: Marc Runyard TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET 4416 Riverfront Blvd cnY Everett STATE •��J�� A ZIP 98203 OWNER PHONE:na OWNER EMAIL:na CONTRACTOR NAME: In House Electric CONTRACTOR ADDRESS: sTReeT1530 117th DR SE cn- Lake Stevens STATE WA Zl,98258 CONTRACTOR PHONE:4257603203 CONTRACTOR EMAIL:ihepermitS@p.gmaiLCOm CONTRACTOR LIC.#(REOUIRED):inhoues952gg CITY OF EVERETT BUSINESS LIC.#(REQUIRED):044168 PRIMARY CONTACT: DOWNER [✓CONTRACTOR ['OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:4253209149 Kelsey CONTACT EMAIL:kelsey@inhouseelectric.com AGREEMENT:1 hereby certify 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 work for which application Is made and t comply with the State Coat ctors Law 18.27 RCW and 296.200 WAG. City of Everett Official use Only PERMIT#: JI °f E \c10 5 - Owner/Auth rized Agent Signature ` Date i (Revised 1/11/2019) Page 1-Application Scanned with CamScanner