4875 ALPINE DR 2019-07-12 - Laserfiche WebLink

ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 1 FAX 425-257-8857 1(E)everetteps@everettwa.gov 1 www.everettwa.gov/permits -.,.. 'PROJECT'SITE INFORMATION . , PROJECT ADDRESS: 4875 Alpine Dr BUILDING AREA: sq ft PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ADDITION ❑TENANT IMPROVMENT ❑ REMODEL BUILDING USE: E1 SFR ❑TOWNHOUSE ❑ DUPLEX ❑ADU ❑ MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL SIECTRIAL APPLICATION INFORMATION &,.DESCRIPTION OF:r rORK,,, ,,, CONTRACT PRICE OF WORK:$300 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: 1 alt circuit (rewire 2 outdoor lights) THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ❑ NO 2 YES-Select Scope: ❑Service ❑ Feeder ©Circuits-#: 1 ❑Complete Re-wire LOW VOLTAGE WORK? E 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 COMPLIANCE ' , IS THIS PERMIT EDUCATION,INSTITUTIONAL, HEALTH AND/OR PERSONAL CARE FACILITIES: E NO ❑YES--See Below&Pg.2 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: 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. W. TZ,''', ..'..Z__ rN .tk.. cQNTACT INFORM/RiTi©N.. ... . \ OWNER NAME:Jenny Marshall TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: sTREET4875 Alpine Dr CITY Everett STATE WA ,,,98203 OWNER PHONE: 25-830-6384 OWNER EMAIL: yourcleanspace@yahoo.com CONTRACTOR NAME: Switch Electric CONTRACTOR ADDRESS: STREET7226 139th Ave NE CITYLake Stevens STATE WA ZIP 98258 CONTRACTOR PHONE:425-244-5511 (CONTRACTOR EMAIL:service@ myswitchelectric.com CONTRACTOR LIC.#(REQUIRED):SWI I CEL91 HK CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 052557 PRIMARY CONTACT: DOWNER ECONTRACTOR ['OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:253-376-7662 Tiffany Erickson CONTACT EMAIL:tiffany@ myswitchelectric.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 and I comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only PERMIT#: ,r��7 Apg L /-� 4/9/19 E noA -' v ZS Owner/Authorized Agent Signature Date (Revised 1/11/2019) Page 1-Application