1402 RAINIER AVE 2019-07-24 - Laserfiche WebLink

uss■ ELECTRICAL PERMIT APPLICATION EVERETT CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 WASHINGTON (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps@everettwa.gov 1 www.everettwa.govlpermits PROJECT SITE INFORMATION PROJECT ADDRESS: 1402 Rainier Ave BUILDING AREA: sq ft PROJECT TYPE: ❑NEW CONSTRUCTION ❑ADDITION El TENANT IMPROVMENT ❑ REMODEL BUILDING USE: ❑✓ SFR ❑TOWNHOUSE ❑ DUPLEX ❑ADU ❑ MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL ELECTRICAL APPLICATION INFORMATIONS DES itIPtION OF'WORK CONTRACT PRICE OF WORK:$ 5360.00 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: Retro t-stat and reconnect furnace THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ❑ NO ❑YES-Select Scope:❑Service ❑Feeder ❑ Circuits-#: El Complete Re-wire LOW VOLTAGE WORK? El NO ❑✓ YES-#of Devices: SELECT SCOPE(REQUIRED): ❑ Data El Intercom ❑✓ Thermostat ❑Audio ❑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: ✓❑ NO ❑YES--See Below&Pg.2 By checking this box,I am stating that I have read and understand all of WAC 29646B-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: ❑✓NO EYES-See Below&Pg.3 nt l 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: Rosie Richardson TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET 1402 Rainier Ave CITY Everett STATE �•�J�JA ZIP(�9820(J 1 OWNER PHONE:425-512-7641 OWNER EMAIL: CONTRACTOR NAME: Nordstrom Heating &Air CONTRACTOR ADDRESS: srREEr4717 87th Ave NE C,TY Marysville STATE WA a1P 98270 CONTRACTOR PHONE:360-386-9819 CONTRACTOR EMAIL:Office Q@nordstromheating.corn CONTRACTOR LIC.#(REQuiRED):nordsha884jw CITY OF EVERETT BUSINESS LIC.#(REQUIRED):042741 PRIMARY CONTACT: DOWNER ❑✓CONTRACTOR DOTHER(Please Specify) CONTACT NAME: CONTACT PHONE:360-386-9819 Debbie or Cheryl CONTACT EMAIL:office@nordstromheating.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 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#: e./6-01 (t) - / 9 E Owner/Authorized Agent Signature Date (Revised 1/11/2019) Page 1-Application