Laserfiche WebLink
ELECTRICAL P*MIT & FIRE ALARM PLMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 I (E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> _477 <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS:2428 OAKES AVE#2 <br /> PROJECT TYPE: 0 NEW CONSTRUCTION ❑ADDITION El TENANT IMPROVMENT ❑ REMODEL <br /> BUILDING USE: El SFR ❑TOWNHOUSE El DUPLEX El ADU El MULTI-FAMILY-#OF UNITS: El COMMERCIAL <br /> BUILDING AREA: sq ft <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK:$1500 ASSOCIATED BUILDING PERMIT#(if applicable): <br /> IS THIS LOW VOLTAGE WORK? El NO El YES-#OF DEVICES: <br /> IS THIS A FIRE ALARM PERMIT? El NO ❑ YES-Plans required for review(Both Electrical and Fire Department inspections are required) <br /> DESCRIPTION OF WORK & CODE COMPLIANCE <br /> DESCRIPTION OF WORK: EMERGENCY REPAIR OF PANEL WHILE WAITING FOR CORRECT PARTS OR REPLACEMENT <br /> IS THIS PERMIT EDUCATION,INSITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: El NO 171 YES--See Below&Pg.2 <br /> n' I 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 <br /> of this application(see next page),AND Plan Review is NOT required because I meet all of the following sub sections that do not <br /> See Page 2 require Plan Review. <br /> ARE YOUAN OWNER PERFORMING WORK AS THE CONTRACTOR WITHOUT ELECTRICAL LICENSURE:El NO EYES-See Below&Pg.3 <br /> I <br /> I Pursuant to RCW 19.28.261,property owners and leaseholders cannot perform electrical work on buildings for rent,sale,or lease without <br /> the proper electrical licensing and certification,or exemption.By checking this box,I am stating that I have completed and signed the <br /> See Page 3 AFFIDAVIT on page 3 of this application to receive an exemption from this licensing/certification requirement. <br /> CONTACT INFORMATION <br /> OWNER NAME:HIDEKO SMITH TENANT BUSINESS NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 13000 ADMIRALTY WAY A-102 <br /> CITY EVERETT STATE WA zip 98204 <br /> OWNER PHONE:425.622.3252 OWNER EMAIL: <br /> CONTRACTOR NAME:EYLANDER SALES& SERVICE <br /> CONTRACTOR ADDRESS: STREET3601 EVERETT AVE <br /> crry EVERETT STATE WA zip 98201 <br /> CONTRACTOR PHONE:425.259.2161 CONTRACTOR EMAIL: <br /> CONTRACTOR LIC.#(REQUIRED):EYLANSS142LP CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 013363 <br /> PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR ✓❑OTHER(Please Specify) <br /> CONTACT NAME:L I L J O H N n Y CONTACT PHONE:425.231.2275 <br /> CONTACT EMAIL: <br /> 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 <br /> 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 <br /> provisions of any other state or local law regulating construction or the performance of construction. That/am authorized by the owner of this property to perform the <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> PERMIT# <br /> 1/74 <br /> Ow er/Author e, < ignature Da (Revised 11/5/2018) Page 1-Application <br />