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

a•I ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES EVERETT 3200 CEDAR STREET,EVERETT,WA 98201 WASHINGTON (P)425-257-8810 I FAX 425-257-8857 I(E)everetleps@evereltwa.gov I www.everettwa.govipermits PROJECT SITE INFORIVIRTIplit PROJECT ADDRESS: 1708 W Mukilteo Blvd Everett !BUILDING AREA: sq ft PROJECT TYPE: 0 NEW CONSTRUCTION 0 ADDITION 0 TENANT IMPROVMENT EJ REMODEL BUILDING USE: Ei1 SFR 0 TOWNHOUSE 0 DUPLEX 0 ADU 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL ELEcTRtc.44,Apppoimp1ikt„toRmATIoNAjasptitmotipkwq. CONTRACT PRICE OF WORK:$ 800 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? 0 NO 0 YES-Select Scope;0 Service 0 Feeder 0 Circuits-#:1 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): CORE ' IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH ANDIOR PERSONAL CARE FACILITIES: NO M YES—See Below&Pg.2 E By checking this box,I am stating that I have read and understand all of WAC 296465.900,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 OWNER PERFORMING WORK AS THE CONTRACTOR WITHOUT ELECTRICAL LICENSURE:ONO 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 from this licensingicertification requirement. It /M .:10,0MTACTIM4EORMATiOttra OWNER NAME: Ron Nasoimientd TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET 1708 W IVIuldteo Blvd CRY Everett STATE VVA ZIP 98203 OWNER PHONE:Da OWNER EMAIL:na CONTRACTOR NAME: In House Electric CONTRACTOR ADDRESS: sTREET1530 117th DR SE cay Lake Stevens STATE WA z,98258 CONTRACTOR PHONE:4267603203 CONTRACTOR EMAIL:ihepermits@gmail.COM CONTRACTOR LIC.#(REOUIRED):inhoues952qg CITY OF EVERETT BUSINESS LIC.#(REQUIRED):044168 PRIMARY CONTACT: DOWNER ['CONTRACTOR DOTHER(Please Specify) CONTACT NAME: CONTACT PHONE:4253209149 Kelsey CONTACT EMAIL:kelsey@inhouseelectric.com AGREEMENT:thereby certify that!have read end 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 ar 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. a performance of construction. That I am authorized by the owner of this property to perform the work for which application is made and I comply with the fate Gontract.rs w 18.27 RCW end 298.200 WAG. City of Everett Official Use Only PERMIT#: .1( 1-7/ 1671 Ow Authorized Agent -gnature te (Revised 171112019) Page 1-APPlIcation Scanned with CamScanner