2615 MAPLE ST 2019-07-24 - Laserfiche WebLink

#111117-74ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 I (E)everetteps@everettwa.gov I www.everettwagov/permits kx\ > ?41141/„ ra t tT{IQ,,A i is `ess PROJECT ADDRESS: 2615 MAPLE ST BUILDING AREA: 3069 sq ft PROJECT TYPE: El NEW CONSTRUCTION ❑ADDITION ❑ TENANT 1MPROVMENT ❑✓ REMODEL BUILDING USE: ❑✓ SFR ❑TOWNHOUSE ❑ DUPLEX ❑ADU El MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL CONTRACT PRICE OF WORK:$ 3511.40 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: PANEL CHANGE 200 AMP THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ❑NO ✓❑YES-Select Scope:❑Service El Feeder El Circuits-#: ❑Complete Re-wire LOW VOLTAGE WORK? ✓❑NO ❑YES-#of Devices: SELECT SCOPE(REQUIRED): El Data ❑ Intercom El 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):PANEL CHANGE IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: I✓ NO YES--See Below&Pg.2 S 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 YOUAN OWNER PERFORMING WORK AS THE CONTRACTOR WITHOUT ELECTRICAL LICENSURE: DNO DYES-See Below&Pg.3 7 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. yg°t�,, ��v ^fl 4� z,1 ,Y ti % 7 r � c ilii rc Man s s Y31t+th ) 'r�a�, Y � 11PS.n'.' t 'Ci R �2 ,� t , ° o �" OWNER NAME: TERESA FISHER TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET 2615 MAPLE ST ��I cr-, EVERETT STATE v VA ZIP 98201 OWNER PHONE:425-231-4129 OWNER EMAIL:FISHERJOE2615@COMCAST.NET CONTRACTOR NAME: GS HEATING, COOLING& ELECTRICAL LLC CONTRACTOR ADDRESS: STREET 3409 EVERETT AVE cmy EVERETT STATE WA Zip 98201 CONTRACTOR PHONE:425-610-4257 CONTRACTOR EMAIL:SARA@GSHEATING.COM CONTRACTOR LIC.#(REQUIRED):GSHEAHC8218R CITY OF EVERETT BUSINESS LIC.#(REQUIRED):60058 PRIMARY CONTACT: ❑OWNER 000NTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:425-610-4257 SARA HOLLAND CONTACT EMAIL:SARA@GSHEATI NG.COM AGREEMENT.1 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 lam authorized by the owner of this property to perform the work for which application is made and 1 comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only PERMIT#: � SU, sf. � ERDS _ � Owner/Authorized Agent i nature Date (Revised 1/11/2019) Page 1-Application