6518 CADY RD 2019-08-07 - Laserfiche WebLink

`; ELECTRICAL PERMIT APPLICATION EVERETT 32CITY OF EVERETT PERMIT SERVICES 00 CEDAR STREET.EVERETT WA 98201 WASHINGTON (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I w%wieverettwa govlperm is PROJECt:$ITE INFORMATION PROJECT ADDRESS: 6518 Cady Rd. BUILDING AREA: sq ft PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ADDITION ❑TENANT IMPROVMENT ©REMODEL BUILDING USE: © SFR ❑„TOWNHOUSE ❑ DUPLEX ❑ADU ❑MULTI-FAMILY-#OF UNITS ❑COMMERCIAL :W.LEC ICAL APPLICATION INFORMATION'SYDESCRIPTION OF WORK CONTRACT PRICE OF WORIZ:$ ASSOCIATED BUILDING PERMIT#(if applicable) E0904-156 DESCRIBE SCOPE OF WORK: For work done in the past. Reference old permit#E0904-156 THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? © NO ❑YES-Select Scope:❑ Service ❑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) Smoke Detector Installation CODE COMPLIANCE IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: © NO ❑YES—See Below&Pg 2 n1 J 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: ZNO 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. CONTACT INFORMATION OWNER NAME: Jim and Shelly Fine TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET 10121 Evergreen Way, Suite 25-277 t�� c - Everett STATE WA zlp 98204 OWNER PHONE:425.350.7771 OWNER EMAIL:shellymadisonfine@gmail.com CONTRACTOR NAME: Seahurst Electric, Inc. CONTRACTOR ADDRESS: STREET2915 Chestnut St. CITY Everett STATE +�r1j�J A ZIP 98201 CONTRACTOR PHONE:425.258.1882 CONTRACTOR EMAIL:swillmorth@seahurst.Com CONTRACTOR LIC.#(REQUIRED):SEAHUE1099QN CITY OF EVERETT BUSINESS LIC.#{REOUIRED): 18763 PRIMARY CONTACT: DOWNER ❑✓CONTRACTOR ❑OTHEFflPiease Specify) CONTACT NAME: CONTACT PHO,N 425.258.5111 Jack Southwick CONTACT EMAIL:jsouthwick@seahurst.com OR swillmorth@seahurst.com AGREEMENT I hereby certify that I have read and examined this application acid 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 1 am authorized by the own rs properly 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 or Everett Official Use Only PERMIT#: Owner/Authorized Agent Signature Date (Revised 1/11/2019) Page 1-Application