905 MADISON ST MADISON PUB 2019-11-06

Elm in L`EECTRICAL PERMIT APPLILATION EVERETT CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 WASHINGTON (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps@everettwa.gov 1 www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 905 Madison St Everett 98203 BUILDING AREA: 2000 sq ft PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ADDITION ✓❑TENANT IMPROVMENT ❑ REMODEL BUILDING USE: LI SFR •, OWNHUSE ❑ DUPLEX CIADU ❑ MULTI-FAMILY-#OF UNITS: CICOMMERCIAL ELEC A ,P A LICATION tNI ORMATI#�N 8l,CE CR>fRT t N OF WORK CONTRACT PRICE OF WORK:$ 5000 7 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WO K: Change out existing ele' •I service equipment, no service increase. Rewire Branch Circuits, Change out lighting to all new LED fixtures THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ❑ NO ❑✓ YES-Select Scope: ✓❑ Service ✓❑ Feeder ✓❑ Circuits-#:20 ❑ Complete Re-wire LOW VOLTAGE WORK? ✓❑ NO ❑YES-#of Devices: SELECT SCOPE(REQUIRED): ❑ Data ❑ Intercom El Thermostat El 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): CODE COMPLIANCE IS THIS PERMIT EDUCATION, INSTITUTIONAL, HEALTH AND/OR PERSONAL CARE FACILITIES: 0 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: ONO • - -low&Pg. 3 Pursuant to RCW 19.28.261, property owners and leaseholders cannot perform electrical work on build . -• ale, or le: e without the proper electrical licensing and certification, or exemption. By checking this box, I am stat•..at I have completed and See Page 3 signed the AFFIDAVIT on page 3 of this application to receive an exemption from this licensi..1 ertification requirement. \ CONT`4 T.INFORMATION 7 ' ; , OWNER NAME: Ron Stangey TENANT BUSINESS NAME(If Comme¢cial): Madison Ave Pub OWNER MAILING ADDRESS: STREET 905 Madison St Wk �, C1, Everett STATE A ZIP 98203" OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: Eco Electric & Plumbing CONTRACTOR ADDRESS: STREET126 S Spokane St CITY Seattle STATE WA ZIP 98134 CONTRACTOR PHONE:206-232-0838 CONTRACTOR EMAIL:csr@ecoelectricwa.com CONTRACTOR LIC.#(REQUIRED): E.IflSt-(7ITY OF EVERETT BUSINESS LIC.#(REQUIRE ) ,.,,4 PRIMARY PRIMARY CONTACT: DOWNER ['CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:808-345-6267 Scott Thompson CONTACT EMAIL:scott@ecoelectricwa.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#: ERG Robin E Lehrbaum 6/18/2019 ` `O(. 7 ^ 7 Owner/Authorized Agent Signature Date (Revised 1/11/2019) Page 1-Application