913 33RD ST B 2022-05-19 - Laserfiche WebLink

i ILIELECTRICAL PERMIT APPLIdAtION CITY OF EVERETT PERMIT SERVICES EVERETT 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.govlpermits WASHINGTON PROJECT SITE INFORMATION PROJECT ADDRESS; 913 33rd ST #B Everett, WA 98201 jBUILDING AREA: sq ft PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ ADDITION El TENANT IMPROVMENT ❑ REMODEL BUILDING USE: ❑ SFRELEC' TOWNHOUSE ❑ DUPLEX ❑ADU n MULTI-FAMILY #OF UNITS: ❑ COMMERCIAL ,4 r A; PLicJd1TIQN It SPR TION,&0ESCA1/11QN.OF.WPMc - _ - ... CONTRACT PRICE OF WORK: OM. )2.-- !ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WO} .K: (2) 120v 20AMP ciricuis for septic control box.. THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ✓❑ NO ❑YES-Select Scope: El Service ❑ Feeder ❑ Circuits#:2 ❑ Complete Re wire LOW VOLTAGE WORK?i 0 NO ❑YES-#of Devices: SELECT SCOPE(REQUI4D) ❑ 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. E Other(List All): -' CODE COMPLIANCE' ,, '� IS THIS PERMIT EDUCATION,,INSTITUTIONAL,HEALTH ANDIOR PERSONAL CARE FACILITIES: L✓J 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. ARE YOU AN OWNER PERFORMING WORK AS THE CONTRACTOR WITHOUT ELECTRICAL LICENSURE: t NNO 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 L I without the propar 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. ONTii CT IN'FORMA TION � ', .�� °��:' OWNER NAME: Burgerg TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS! STREET 913 33rd St#B ciTv ZIP 98201 Everett STATE WA r OWNER PHONE:206-730-19898 'OWNER EMAIL: p CONTRACTOR NAME: Beacon Plumbing CONTRACTOR ADDRESS: 5TREET861 1 S 192nd St c,-, Kent STATE wa ZIP 98031 CONTRACTOR PHONE:206,-720-2040 (CONTRACTOR EMAiL:Guiana©beaCOnpiumbing.net CONTRACTOR LIC.#(REQUIRED):UEACOPM856P6 'CITY OF EVERETT BUSINESS LIC.#(REQUIRED) 043941 amu,- ..6 PRIMARY CONTACT: DOWNER [✓CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:206-730-9898 r Frank .Anderson CONTACT EMAIL:Guiana©beaconpIUmbing`.net rra vl ..- AGREEMENT:I hereby certify thatlf 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 f am authorized by the owner of this property to perform the work for which application is made and I City of Everett Official Use Only with the State Contractors Law 18.27 RCW and 296.200 WAG. PERMIT#: I ,r( i k . + I ,\ Pa e'I-Application O er •uthorized Age Signature Date (Revised 1/11/2019) g pp 1