1703 73RD ST SE 2019-08-13 - Laserfiche WebLink

ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES NrdOYETT 3200 CEDAR STREET, EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps@everettwa.gov I www.everettwa.gov/permits TION PROJECT ADDRESS: Brandon Blakley 3c St-- apILDING AREA: 1378 sq ft PROJECT TYPE: LI NEW CONSTRUCTION ❑ADDITION ❑TENANT IMPROVMENT REMODEL BUILDING USE: C✓J SFR ❑TOWNHOUSE El DUPLEX ❑ADU ❑ MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL ELEC `RI c X04 , I[ ' '.,. rilvc n . "IOilti1 off WORK CONTRACT PRICE OF WORK:$ 2500 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: 200AMP Service Upgrade and Panel 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 E Audio El 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): COD C0 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. ARE YOU AN OWNER PERFORMING WORK AS THE CONTRACTOR WITHOUT ELECTRICAL LICENSURE: ,LINO 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. OWNER NAME: Brandon Blakley TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET 1703 73rd St SE crry Everett STATE WA ZIP 98203 OWNER PHONE:425-210-4021 OWNER EMAIL:brandon.j.blakley@boeing.com CONTRACTOR NAME: SeaTown Electric Corp. CONTRACTOR ADDRESS: STREET 3431 Broadway CITY Everett STATE WA Zip 98201 CONTRACTOR PHONE:206-905-4946 CONTRACTOR EMAIL:permits@seatownservices.com CONTRACTOR LIC.#(REQUIRED):SEATOEC86ORB CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 53916 PRIMARY CONTACT: ❑OWNER ✓❑CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:206-905-4946 Bekah Swanson CONTACT EMAIL:permits@seatownservices.com AGREEMENT'I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions oflaws 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 Stat.Contractors Law 18.27 RCW and 296.200 WAC. Ci of Everett Official Use Ont cx) PERMIT#: 4/4/19 E o(4 _DSL Ownert tath.,izeThAgent Signature Date 1Rewsed 1)11/2019) Page 1-Application