218 96TH PL SE 2019-08-14 - Laserfiche WebLink

min ELECTRICAL PERMIT APPLICATION EVERETT CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 WASHINGTON (P)425-257-8810 I FAX 425-257-8857 i(E)everetteps@everettwa.govI www.everettwa.gov/permits PRO4MECT SMTE 1NFORMA '1_ON,'.-` PROJECT ADDRESS: 218 96th Place SE BUILDING AREA: 1072 sq ft PROJECT TYPE: El NEW CONSTRUCTION El ADDITION El TENANT IMPROVMENT El REMODEL BUILDING USE: ❑✓ SFR ❑TOWNHOUSE El DUPLEX El ADU El MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL _�..,._�-... ._f.� E �' � K. _ T1 �1N T �B=D SORIP:T ;<O- --- - -- - ..�:;: _.�_�_-_ .._._ ...� ._...0 SOA ..AR �L#a�:. , 0 . ._ M ____ _�....::.._::.,.,_..,.k_-_.._..:..__�. . i�.._Y Y.�_�.. iP:.._.^.... .1�,_�_,�QI�_..-A. _.N< � ,.�_ . _..��..... ...:�1�:..�„.�111�.;�..��W�-...._...>:.____�.._,_.._._... CONTRACT PRiCE OF WORK:$ 11,314 ASSOCIATED BUILDING PERMIT#(if applicable): MI905-027 DESCRIBE SCOPE OF WORK: Install circuits for ductless heat pump with two indoor heads THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT AP LY) LINE VOLTAGE WORK? El NO El YES-Select Scope:El Service ❑Feed r El Circuits-#:4 • Complete Re-wire LOW VOLTAGE WORK? ✓❑NO El YES-#of Devices: SELECT SCOPE(REQUIRED): El Data ❑Intercom El Thermostat ❑Audi ❑Secure • =ss 0 Security System El 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. El Other(List All): _ r : , ... - .." _ .:: ._: :: }. OPECO V.I,PLIANOE; ,.,_n,__ _.. , .., .,. , .:.,g 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 296.468.900,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 Pian Review. ARE YOU AN OWNER PERFORMING WORK AS THE CONTRACTOR WITHOUT ELECTRICAL LICENSURE: :WO OYES-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. ..may::::.' <.;<^.�';s - ..�.?-. J:r"'-"--ML - i.� :.Stir:{.'- .cwks. y^-.�-.::�^ �:e..--,.>_.,"._�`^sinAt`i�,:=:�,�:^'.-�w::-,_.�:��:G-•=i.:'xc.=<m4ti..�._..1!-�... .. �,,..�..•,-.,�..-..,-.....:... .....:. ....... .........��. un..:..�.,..�� _ ..ai r^.<.. .� .[s :. G...✓c_...s_ ,O �A��N O IVIA��4N OWNER NAME: Mary Austin TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET 218 96th Place SE CirY Everett STATE YYtp� A p 98208 OWNER PHONE:253-486-7026 OWNER EMAIL:NSA CONTRACTOR NAME: Barron Heating CONTRACTOR ADDRESS: STREET5100 Pacific Highway Suite 103 CRY Ferndale STATE WA 98248 CONTRACTOR PHONE:360-676-1131 CONTRACTOR EMAIL:amandaa@barronheating.com CONTRACTOR LIC.#(REQUIRED):BARROHC855BH CITY OF EVERETT BUSINESS LIC.#(REQUIRED):052470 PRIMARY CONTACT: DOWNER ❑✓CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:360-676-1131 Amanda Allison CONTACT EMAIL:amandaa@barronheating.com AGREEMENT 1 hereby certify that 1 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 levi regulating construction or the performance of construction. That 1 am authorized by the owner of this property to perform the work for which application Is made and! comply with the State Contractors Law 18.27 RCW and 298.200 WAC. City of Everett Official Use Only PERMIT#: . .24.E - 05/08/2019 E .�G\ o SO( ) . Owner/Authorized Agent Signature Date (Revised 1/11/2019) Page 1-Application