1708 W MUKILTEO BLVD 2019-07-08 - Laserfiche WebLink

ELECTRICAL - ERMIT & FIRE ALARM P_. _MIT APPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 1 (E)everetteps@everettwa.gov( www.everettwa.gov/permits • PROJECT SITE INFORMATION PROJECT ADDRESS: 1708 W Mukilteo Blvd Everett, WA 98203 PROJECT TYPE:CNEW CONSTRUCTION ❑ADDITION 0 TENANT IMPROVMENT REMODEL BUILDING USE: la SFR 0 TOWNHOUSIDUPLEX ❑ DU ❑ MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL BUILDING AREA: approx 2800 sq ft ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK:$925 ASSOCIATED BUILDING PERMIT#(if applicable): IS THIS LOW VOLTAGE WORK? 0 NO ❑YES-#OF DEVICES: IS THIS A FIRE ALARM PERMIT? ©iN1O 0 YES-Plans required for review(Both Electrical and Fire Department inspections are required) DESCRIPTION OF WORK& CODE COMPLIANCE DESCRIPTION OF WORK: New 20 amp circuit for 2 outlets THIS SECTION APPLIES TO ALL EDUCATION,INSITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: UBy 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. ATTENTION OWNERS:THIS SECTION IS FOR OWNERS PERFORMING WORK AS THE CONTRACTOR WITHOUT ELECTRICAL LICENSURE: ® 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 signed the See Page 3 AFFIDAVIT on page 3 of this application to receive an exemption from this licensing/certification requirement. CONTACT INFORMATION OWNER NAME: Ron Nascimiento TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET 1708 W Mukilteo BIv cm• Everett STATE wa ZIP 98203 OWNER PHONE: na OWNER EMAIL: na CONTRACTOR NAME: In House Electric CONTRACTOR ADDRESS: STREET 1530 117th DR SE c,n, Lake Stevens STATE WA ZIP 98258 CONTRACTOR PHONE:4257603203 CONTRACTOR EMAIL: ihepermits@gmail.com CONTRACTOR LIC.#(REQUIRED):inhoues952gg CITY OF EVERETT BUSINESS LIC.#(REOUIRED): 044168 PRIMARY CONTACT: DOWNER CDONTRACTOR I 0/OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 4257603203 Kelsey 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 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:• amply with the State Contractors Law 18.27 RCW and 296.200 WAC. / City of Everett Official Use Only PERMIT# /21• //q Own,r/Authorized Ayr t'Signature Date (Revised 10/30/2018) Page 1 of 3 Scanned with CamScanner