7713 LOWER RIDGE RD 2019-07-24 - Laserfiche WebLink

ELECTRICAL PERMIT APPLICATION EVERETT 32CITY OF EVERE I I PERMIT SERVICES 00 CEDAR STREET,EVERETT,WA 98201 WASHINGTON (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 7713 Lower Ridge Rd BUILDING AREA: sq ft PROJECT TYPE: ❑NEW CONSTRUCTION LI ADDITION ❑TENANT IMPROVMENT ❑ REMODEL BUILDING USE: SFR ❑TOWNHOUSE ❑DUPLEX ❑ADU ❑MULTI-FAMILY-#OF UNITS: ❑ COMMERCIAL ELECTRICAL APPLICATION INFORMATION &DESCRIPTION OF WORK CONTRACT PRICE OF WORK:$ 6683.00 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: Retro t-stat and reconnect AC unit THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ❑ NO ❑YES-Select Scope:❑Service El Feeder ❑ Circuits-#: ❑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: L✓J NO rnYES--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 OYES-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: Debbie Krogen TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET 7711 Lower Ridge Rd CITY Everett STATE WA zip 98203 OWNER PHONE:425-999-7291 OWNER EMAIL: CONTRACTOR NAME: Nordstrom Heating &Air CONTRACTOR ADDRESS: SWWEET4717 87th Ave NE CITY Marysville STATE WA zip 98270 CONTRACTOR PHONE:360-386-9819 CONTRACTOR EMAIL:office@nordstromheating.com CONTRACTOR LIC.#(REQUIRED):nordsha884jw CITY OF EVERETT BUSINESS LIC.#(REQUIRED):042741 PRIMARY CONTACT: El OWNER ['CONTRACTOR ['OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:360-386-9819 Debbie or Cheryl CONTACT EMAIL:office@nordstromheating.com AGREEMENT:I hereby certify that I have read and examined this application and know the same to be true and correct. Alt provisions of laws and ordinances governing this type of work will be completed whether specified herein or not. Tho 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 PERMIT#: - 1 -t E „904 - O q— weer/Authoriz Agent Signature Date (Revised 1111/2019) Page 1-Application