5020 COLLEGE AVE 2019-08-07 - Laserfiche WebLink

ELECTRICAL 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.everettwa.govfpermits 477 PROJECT SITE INFORMATION PROJECT ADDRESS: 5020 college ave BUILDING AREA: 2200 sq ft PROJECT TYPE: ❑NEW CONSTRUCTION ❑ADDITION ❑TENANT IMPROVMENT Ell REMODEL BUILDING USE: El SFR ❑TOWNHOUSE ❑ DUPLEX ❑ADU IE MULTI-FAMILY-#OF UNITS:4 El COMMERCIAL ELECTRICAL APPLICATION INFOR A'TION&.'DE RIPTI 14..QF..WOR C.. CONTRACT PRICE OF WORK:$ 7000 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: replace 4 unit electrical panels, no load change THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ❑ NO ©YES-Select Scope: D Service ❑Feeder ❑Circuits-#: ❑Complete Re-wire LOW VOLTAGE WORK? CI NO ❑YES-#of Devices: SELECT SCOPE(REQUIRED): ❑ Data ❑ Intercom El Thermostat ❑Audio El Secure Access El 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): 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 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. DYES YOU AN OWNER PERFORMING WORK AS THE CONTRACTOR WITHOUT ELECTRICAL LICENSURE: Lrr�—It NO ❑YES-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. OWNER NAME: Boyd Daniels TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET 5020 college ave c,n Everett STATE WA Z,P 98203 OWNER PHONE:206-505-9435 OWNER EMAIL;boyddaniels@comcast.net CONTRACTOR NAME; Eagle Electric of Auburn LLC CONTRACTOR ADDRESS: STREET PO BOX 1422 CITY Auburn STATE WA zip 9.• - CONTRACTOR PHONE:253-833-9230 CONTRACTOR EMAILaeff@eagleelectriCOnline.Com a` CONTRACTOR LIC.#(REQUIRED):EAGLEEA911LC CITY OF EVERETT BUSINESS LIC.#(REQ `RED): � � PRIMARY CONTACT: DOWNER ❑CONTRACTOR ['OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:425-466-9286 Jeff CONTACT EMAIL:jeffaf`)eagleelectriconline,com AGREEMENT I hereby certify that/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 =1�,. PERMIT#: ,, _ E 9o3 _ X22 OwnVetAtithorized Agent Signature Date (Revised 1/11/2019) Page 1-Application