512 MORGAN RD 2019-07-08 - Laserfiche WebLink

ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES f� 3200 CEDAR STREET,EVERETT,WA 98201 �wr (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps@everettwa,gov I www.everettwa.govlpermlls PROJECT SITE INFORMATION PROJECT ADDRESS: 512 Morgan RD Everett 98203 BUILDING AREA: sq ft PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ADDITION ❑TENANT IMPROVMENT ❑REMODEL BUILDING USE: El SFR ❑TOWNHOUSE ❑DUPLEX ❑ADU ❑MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL ELECTRICAL APPLICATION INFORMATION&DESCRIPTION OF WORK CONTRACT PRICE OF WORK:$ 1800 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: 15 amp circuit for(1) light THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE:(SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ❑NO ❑YES-Select Scope:❑Service ❑Feeder ❑✓ Circuits-#:1 ❑Complete Re-wire LOW VOLTAGE WORK? ❑NO ❑YES-#of Devices: SELECT SCOPE(REQUIRED): ❑Data ❑Intercom ❑Thermostat ❑Audio ❑Secure Access ❑Security System ❑ 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: ❑NO ❑YES—See Below&Pg.2 By checking this box.I am stating that I have read and understand all of WAC 296-468-900,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:ENO 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. .CONTACT INFORMATION OWNER NAME: Mitch Sickler TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET 512 Morgan RD crry Everett STATE wa zip 98203 OWNER PHONE:ria OWNER EMAIL:na CONTRACTOR NAME: InHouse Electric CONTRACTOR ADDRESS: STREET1530 117thDR SE crry Lake Stevens STATE WA z, 98258 CONTRACTOR PHONE:4257603203 CONTRACTOR EMAIL:ihepermits@gmail.com CONTRACTOR LIC.#(REQUIRED):inhoues952gg CITY OF EVERETT BUSINESS LIC.#(REQUIRED):044168 PRIMARY CONTACT: DOWNER ['CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:4257603203 ke lsey CONTACT EMAIL:ihepermits@gmail.com 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 . plated whethy sr: die.herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other stale or Focal lawbgutating .nstruclion/ p.rform.rice of construction. That I em authorized by the owner of this property to perform the work for which application is made and I comply th the •ate Contract. aw 8.27"CW and 298.200 WAC. City of Everett Official Use Only PERMIT#: " E Ow4ner/Authorized Age Sig ature LiDate (Revised 1/11/2019) Page 1-Application Scanned with CamScanner