818 94TH ST SE 2019-08-14 - Laserfiche WebLink

ELECTRICAL PRMIT & FIRE ALARM PMIT APPLICATION CITY OF EVERETT PERMIT SERVICES 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 jk-n- PROJECT SITE INFORMATION PROJECT ADDRESS:818 94th St. SE.Everett,WA 98208 PROJECT TYPE: 0 NEW CONSTRUCTION ❑ADDITION ❑TENANT IMPROVMENT ✓❑ REMODEL BUILDING USE: ❑✓ SFR El TOWNHOUSE El DUPLEX El ADU El MULTI-FAMILY-#OF UNITS: ❑ COMMERCIAL BUILDING AREA:' _ado sq ft ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK:$2500.00 'ASSOCIATED BUILDING PERMIT#(if applicable):BI809-036 IS THIS LOW VOLTAGE WORK? IZNO ®YES-#OF DEVICES: 4 IS THIS A FIRE ALARM PERMIT? O NO ❑ YES-Plans required for review(Both Electrical and Fire Department inspections are required) DESCRIPTION OF WORK & CODE COMPLIANCE DESCRIPTION OF WORK: Upgrade panel, outlets. and existing HVAC systems. Install new lights IS THIS PERMIT EDUCATION,INSITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: ✓0 NO ❑YES--See Below&Pg.2 n11 By checking this box, I am stating tl)sit-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 YOUAN OWNER PERFORMING WORK AS THE CONTRACTOR WITHOUT ELECTRICAL LICENSURE: ONO OYES-See Below&Pg.3 fl 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 signed the See Page 3 AFFIDAVIT on page 3 of this application to receive an exemption from this licensing/certification requirement. CONTACT INFORMATION OWNER NAME: Belay Asfaw TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET 818 94th St SE my Everett STATE WA ZIP 98208 OWNER PHONE:206-354-4095 'OWNER EMAIL:asfaw08@gmail.com CONTRACTOR NAME:Energy Management Services, Inc CONTRACTOR ADDRESS: `STREET 16022 60th Ave. W crry Lynnwood STATE WA zip 98037 CONTRACTOR PHONE:425-273-7300 CONTRACTOR EMAIL:ems@emsiwa.com CONTRACTOR LIC.#(REQUIRED):ENERGMS913B6 CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 48000 ,)PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:425-273-7300 S Ca m Nam CONTACT EMAIL:ems@emsiwa.com AGREEMENT:I 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# ,...te::: :je-4 42 --)8— )3/h2 A .2— 0 Owner/Authorized Agent Signature Date (Revised 11/5/2018) Page 1-Application