805 103RD PL SE 2019-08-14 - 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 1(E)everetteps@everettwa.gov 1 www.everettwa.gcv/permits , Ecr EINFOONO -. PROJECT ADDRESS: 805 103rd PI SE BUILDING AREA: 2245 sq ft PROJECT TYPE: NEW.CONSTRUCTION ❑ADDITION ❑TENANT IMPROVMENT ❑REMODEL BUILDING USE: 0 fSFR ❑TOWNHOUSE 71 DUPLEX El ADU ❑MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL ��' i _ .,... tet....._. :", !....' CONTRACT PRICE OF WORK:$ 1000 ASSOCIATED BUILDING PERMIT#(if applicable): M1904-034 DESCRIBE SCOPE OF WORK: 1 - 30AMP Dedicated circuit for Heat Pump, 1 altered circuit for furnace hook up THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ❑ NO ❑YES-Select Scope: ❑Service ❑Feeder ©Circuits-#:2 ❑Complete Re-wire LOW VOLTAGE WORK? ©NO ❑YES-#of Devices: SELECT SCOPE(REQUIRED): El Data ❑Intercom ❑Thermostat L. Audio ❑Secure Access ❑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. CI Other(List All): � r1 IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: NO El YES--See Below &Pg.2 (-- By checking this box, I am stating that I have read and understand all of WAC 296468-900,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. n ARE YOU AN OWNER PERFORMING WORK AS THE CONTRACTOR WITHOUT ELECTRICAL LICENSURE:ZNO DYES-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 Li 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: Bethany Sokol TENANT BUSINESS NAME(if Commercial): OWNER MAILING ADDRESS: STREET 805 103rd PI SE psi CITY Everett STATE TM'n/A zip 98208 OWNER PHONE:4259419031 [OWNER EMAIL:sokoIbethany@gmail.com CONTRACTOR NAME: SeaTown Electric Corp. CONTRACTOR ADDRESS: sTREcrr3431 Broadway rip t1 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.#(REOUIRED): 53916 PRIMARY CONTACT: DOWNER ©CONTRACTOR [._..)OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:206-905-4946 Beka h Swanson CONTACT EMAIL:permits@seatownservices.com AGREEMENTI 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 f comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only PERMIT#: ti ; "' ✓ 4-9-19 E Owner/A chod tent Signature Date (Revised 1/ 1/2019 Page 1-Application