3419 NORTON AVE 2019-07-08 - Laserfiche WebLink

nen ECTRICAL PERMIT APPLII PION 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.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 3419 Norton Ave Everett WA 98201 BUILDING AREA: , sq ft PROJECT TYPE: ❑ NEW CONSTRUCTION 0 ADDITION 0 TENANT IMPROVMENT ❑REMODEL BUILDING USE: Q SFR ❑TOWNHOUSE ❑ DUPLEX ❑ADU ❑MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL ELECTRICAL APPLICATION INFORMATION & DESCRIPTION.OF WORK CONTRACT PRICE OF WORK:$ 1000.00 'ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: Removal of old heater circuits to make room for new heat pump circuit THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? LI NO ®YES-Select Scope:❑Service El Feeder El Circuits-#:2 ❑Complete Re-wire LOW VOLTAGE WORK? ®NO ❑YES-#of Devices: SELECT SCOPE(REQUIRED): ❑Data ❑ Intercom ❑Thermostat ❑Audio El Secure Access ❑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 CONEOLIANCE IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: El NO El YES--See Below&Pg.2 (1 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 f 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. tv It ARE YOU AN OWNER PERFORMING WORK AS THE CONTRACTOR WITHOUT ELECTRICAL LICENSURE: NO 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. 2 7: f _ NFO:1. :IN OWNER NAME: Kate Haagen TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET 3419 Norton Ave c„v Everett STATE WA z,p 98201 OWNER PHONE:42552312492 ,OWNER EMAIL: CONTRACTOR NAME: Skyline Electrical Services CONTRACTOR ADDRESS: sTREET1 13 Cherry St#75215 cm( Seattle STATE WA zIF 98104 CONTRACTOR PHONE:4252018288 `CONTRACTOR EMAIL:ateX@skylinelectrlc.com CONTRACTOR LIC.#(REQUIRED):SKYLIES82ORD ICITY OF EVERETT BUSINESS LIC.#(REQUIRED):60163 PRIMARY CONTACT: DOWNER ❑CONTRACTOR OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:4252312492 Kate CONTACT EMAIL: AGREEMENT:I 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 Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only yt J PERMIT Owner/Authorized Agent ignature Date (Revised 1/11/2019) Page 1-Application