1908 113TH PL SE 2019-08-14 - Laserfiche WebLink

LLECTRICAL PERMIT APPLIW- TION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 4E7 4* (P)425-257-8810 I FAX 425-257-8857 1 (E)everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 1908 113th pl se BUILDING AREA: 1800 sq ft PROJECT TYPE: ❑ NEW CONSTRUCTION LI ADDITION ✓❑TENANT IMPROVMENT ❑ REMODEL BUILDING USE: LI SFR ✓❑ TOWNHOUSE ❑ DUPLEX ❑ADU ❑ MULTI-FAMILY-#OF UNITS: ❑ COMMERCIAL ELECTRICAL APPLICATION INFORMATION & DESCRIPTION OF WORK CONTRACT PRICE OF WORK:$ 500 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: add designated 25 amp supply circuit to new Daikin ductless heat pump on 2nd story deck from garage pa for primary heating and cooling. THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY)• LINE VOLTAGE WORK? ❑ NO [7]YES-Select Scope: ❑ Service ❑ Feeder 0 Circuits-#:1 ❑ Complete Re-wire LOW VOLTAGE WORK? 0 NO ❑YES-#of Devices: SELECT SCOPE(REQUIRED): ❑ 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. ❑ Other(List All): CODE COMPLIANCE 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 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: ENO 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. CONTACT INFORMATION OWNER NAME: Dayton Lang TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET 1908 113th pl se c,T,, Everett STATE WA zP 98270 OWNER PHONE:206 683 8845 OWNER EMAIL:krl41 @hotmail.com CONTRACTOR NAME: Balance Point Services Inc. CONTRACTOR ADDRESS: STREET 1010 State st. PO Box 1455 Marysville STATE WA zip 98270 CONTRACTOR PHONE:425 508 0124 CONTRACTOR EM lL:James@balancepointservices.com CONTRACTOR LIC.#(REQUIRED):BALANPS912DP(/BALANPC944N C f y OF EVERETT BUSINESS LIC.#(REQUIRED):50604 PRIMARY CONTACT: DOWNER ❑✓CONTRACTOR OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:425 508 0124 James Mason CONTACT EMAIL:James@balancepointservices.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 /711/AAAAt PERMIT#: ZE - � E (9 o -- (Owneuthorized Agent Signature Date (Revised 1/11/2019) Page 1-Application